Peroral endoscopy and laryngeal surgery . o the left. The shoulders should alsoparticipate slightly in this movement. It is in the facility of making thesemovements that one of the great advantages of the Boyce position overthe lateral or any other position for esophagoscopy consists; and had theauthor not had the advantage of team work with a good assistant hold-ing the patient in the Boyce position he could not have developed thishigh-low method to its present approximate perfection. This dropping iNTRonrcTioN oi Tin-; ksopiiacoscopk. 191 of the head was not uiulcrslood hy Alikuhcz ami in or
Peroral endoscopy and laryngeal surgery . o the left. The shoulders should alsoparticipate slightly in this movement. It is in the facility of making thesemovements that one of the great advantages of the Boyce position overthe lateral or any other position for esophagoscopy consists; and had theauthor not had the advantage of team work with a good assistant hold-ing the patient in the Boyce position he could not have developed thishigh-low method to its present approximate perfection. This dropping iNTRonrcTioN oi Tin-; ksopiiacoscopk. 191 of the head was not uiulcrslood hy Alikuhcz ami in order to overcome theangle P S, Fig. 152, he put a htnd in his gastroscope thinking that hehad encountered the dorsal spine when his tube, which was passed blind-ly, encountered the resistance of the diaphragm, against which the esoph-agus was pushed just above the hiatus, because the direction of the tubewas faulty owing to not dropping the head. Mikulicz did not use thedorsal position but doubtless he would have obtained an equivalent of. Fig. 150.—Esophagoscopy by the authors high-low method. Stage ,?. Pass-ing thrcjiigh the thoracic esophagus. dropping the head had he been possessed of a modern o]>en tube gas-troscope passed by sight. The hiatal constriction may assume the formof a slit or more commonly a rosette (Fig. 7, Plate III), and in its ro-sette form has often been mistaken by esophagoscopists for the cardia,leading to the erroneous idea of a sphincter at the cardia. If the ro-sette or slit cannot be promptly found, as may be the case in various de-grees of diffuse dilatation, the tube-mouth must be shifted farther to theleft, and also anteriorly. I f the tube-mouth is centered over the hiatalconstriction, moderately linn i)ressure continued for a short time willcause it to yield. Then the tube, maintaining its same direction will, 192 INTRODUCTION OF THE ESOPHAGOSCOPE. witlKHit further trouble, glide into and through the abdominal cardia will not b
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
