Clinical evaluation of the fiberoptic bronchoscope (Olympus BF 5B) for pediatric endoscopy

Abstract

N DECEMBER 1970, the Liverpool Regional Hospital Board made money available for the purchase of a pediatric gastroscope. This report is based on the clinical experience gained using the Olympus (BF 5B) fiberoptic bronchoscope as a pediatric gastroscope on 41 patients. At present there is no instrument specifically designed as a pediatric gastroscope. Various manufacturers who were approached stated that such an instrument might become available when the backlog of orders for instruments for the various endoscopic units had been completed. The need for pediatric gastroscopy and endoscopy is obvious. The indications for endoscopic examination are different in children than in adults. In most cases, the need is for examination only and biopsy is seldom necessary. Photography, both still and cine, is a desirable extra. The age range of children requiring investigation starts from the neonatal period. The size of the esophagus in a full-term neonate is 9-10 cm in length and 4-6 mm in diameter. The growth in size of the trachea in infants is well known and is related to the age rather than the weight of the child. To determine the size of the required endotracheal tube, anesthetists use a guide based on the age of the child. 1 No such formula is available for judging the size of instrument to be passed clown an infant's esophagus. A 10-mm rigid esophagoscope can be passed easily into the esophagus of a neonate. An adult 13-mm gastroscope can be passed easily in a 7-yr-old patient. Various instruments were inspected and the 5-mm bronchoscope (Olympus BF 5B) was selected with the specifications shown in Table 1. Three deficiencies soon became apparent: the inadequate working length of the instrument, especially in older children; the short depth of focus, preventing a sharp image of objects further than 45 mm away from the tip; and poor-quality photographs of certain areas. Cine photography was unsuccessful with the standard compact light source (CLS).