Technical skills and training of upper gastrointestinal endoscopy for new beginners

Figure 9 Intubation of scope from oral cavity into pharynx. A: The right position of the tongue. Before inserting the endoscope into the oral cavity, it is recommended the the tongue be positioned between the 9 o’clock and 12 o’clock directions on the screen. An advanced endoscopist usually inserts the endoscope into the oral cavity after placing the tongue to the upper left side (11 o’clock direction) on the screen; B: Another example of a properly positioned tongue. In this case, the tongue is placed nearly to the 12 o’clock direction on the screen; C: Inadequately positioned tongue. As the tongue is placed in a wrong position (about 6 o’clock direction in this examinee’s case) on the screen, it becomes difficult to advance the scope further because the intended manipulation of the scope does not coincide with the subsequent movement of the scope displayed on the screen.