The endoscope serves many purposes in dilating oesophageal strictures. If the stricture is about the same diameter as the 'scope, the latter can be used to effect gentle initial dilatation. It also serves to gauge the size of the stricture - the outer diameter of the scope which traverses the impasse.
Guidewires come in many forms, but all should be unkinked and have a flexible tip. Ideally, fluoroscopy should be used for their siting. Calibrated guidewires are preferable in the absence of fluoroscopy for they go some way to eliminating the problem of slip from the site of stenosis as the dilator is passed.
The hollow-core dilators are passed over the guidewire through the biopsy channel of the endoscope. Again, in ideal circumstances, fluoroscopy should be used for siting.
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