Sometimes bile duct cannulation requires orientation of the cannula in a cephalad direction. This can be accomplished by using a sphincterotome. Tightening the cutting wire bows the cannula upward and produces a more cephalad orientation for the tip of th
Lifting the cannula to insert it along the “roof ” of the papilla increases the likelihood of entry into the bile duct.
Cannula placement for laparoscopic placation of perforated ulcer.
Construction of mucosa-lined tube (Janeway-style gastrostomy). A fold of stomach is elevated and the endoscopic stapler applied. Approximately 1 cm of stomach must be included in the staple line to assure an adequate lumen. The tube is grasped and elevate
Open (Hasson) cannula, reusable type.