Which maneuver is used to access the second portion of the duodenum during an endoscopic procedure?

The maneuver that is used to access the second portion of the duodenum during an endoscopic procedure is achieved through "dial up and right with clockwise torque." This technique is focused on the unique anatomy of the duodenum, particularly the orientation and positioning of the endoscope as it navigates through the duodenum's curved anatomy.

When performing this maneuver, the action of dialing up helps to elevate the endoscope and directs it toward the duodenum. At the same time, turning to the right in a clockwise manner assists in maneuvering the endoscope through the sharp turn that leads into the second portion of the duodenum. This method is important because it allows for improved visualization and access to that particular section, thereby facilitating the endoscopic procedure.

The combination of upward movement and rightward torque exploits the natural curves of the gastrointestinal tract, allowing the endoscopist to effectively navigate into the duodenum without causing unnecessary trauma or discomfort. Choices that do not involve this specific combination may not facilitate the necessary angles and positions needed for optimal access to this part of the duodenum.