Types Of Dilators

Esophageal dilators can be divided into two basic groups: the push dilators ( Fig. 8-1 ) and the balloon dilators ( Fig. 8-2 ). The push dilators can be further subdivided into those that require guidewire passage and those that do not. Balloon dilators can be further classified as those requiring fluoroscopic placement and those that can be passed through the endoscope. Other types of dilators that have been advocated but are

rarely used include tapered-tip endoscopes, mechanical dilators with monitoring for width and force of dilatation, and variably tapered plastic sheaths that fit over conventional pediatric or adult endoscopes. Attaching a polyethylene balloon to a bronchoscope as a means of dilating tight strictures or placing a bolus of tape onto the distal shaft of the endoscope above the bending section each

Figure 8-1 The push dilators: mercury dilator (left)', hollow polyvinyl dilator (American) with wire introducer in place (middle)', and Eder-Puestow dilator with flexible tip, olive dilator, and metal introducer (right).

Dilator Flexibel

Figure 8-2 The balloon dilators: achalasia balloon dilator inflated with wire introducer in place (top) and through-the-scope (ITS) system passed through endoscope (bottom).

TABLE 8-2 -- Complication Rates of Esophageal Dilatation

Study

No. of Patients

Dilator Types

Complication Rate (%)

Ogilvie et al. (1980)

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