Endoscopy is a medical procedure that involves the insertion of a long, thin tube directly into the body for visualization of internal organ or tissue in detail.
Using the same principle, endoscopy can be used for imaging and surgery. These are respectively called endoscopic imaging and endoscopic surgeries.
For example, endoscopy is frequently used to find ulcers of the esophagus or stomach which are not visible on conventional images.
The advantage of this procedure is its non-invasive nature. Most of the procedures use natural orifices like mouth, nose, anus, etc to access different organs.
Sometimes, a small incision can be used, as in visualizing the abdominal contents or in joint endoscopy or arthroscopy.
This type of procedure is minimally invasive and is less taxing on the patient as well as resources.
Endoscopes have given rise to new kinds of minimally invasive surgeries, also called endoscopic surgery or keyhole surgery, which requires special instruments and visual screens [endoscopic imaging]. The surgeon can visualize the procedure on the visual screen images produced live by the endoscope and perform the surgery.
Moreover, endoscopy has relatively few risks and is able to provide detailed direct visualization of the tissue [In contrast, CT or MRI provide only images of the region]. Endoscopy is very commonly used in modern medicine and is a powerful diagnostic and therapeutic tool.
Earlier endoscopes required direct visualization. Modern endoscopes can transfer the images on the screen where not only the operator but other people can also watch.
Interestingly, the first endoscope was designed in 1806. We have come a long way since then.
Types of Endoscopy
In all types of endoscopies, the basic tenet remains the same – a tube with a camera. Depending on the region involved, the endoscopic procedures are known by different names [see below]. The endoscope involved is similarly named. Different types of endoscopes have different features to address the varied needs of different regions.
While I list below the names by which it is known in different regions, the basic procedure is the same – endoscopy. The different names are quick means to indicate the site and the procedure.
- Upper GI Endoscopy or also called esophagogastroduodenoscopy
- the examination of the esophagus, stomach and the upper small bowel called the duodenum
- Small intestine- Enteroscopy
- Large intestine/colon- Colonoscopy, sigmoidoscopy
- Rectum- Rectoscopy.
- Nose- Rhinoscopy
- Lower respiratory tract – bronchoscopy
Female reproductive tract (gynoscopy is all-encompassing term)
- Cervix – colposcopy
- Uterus – Hysteroscopy
- Fallopian tubes- Falloposcopy
Those involving a small incision
- Abdominal or pelvic cavity- Laparoscopy
- Interior of a joint- Arthroscopy
- Chest- Thoracoscopy
Capsule endoscopy or Video capsule endoscopy is a recent addition of endoscope which involves a small wireless camera fit into a capsule [just like vitamin tablet] which is to be swallowed.
As the capsule travels through the digestive tract, it takes pictures, which are transmitted to a wearable device usually attached to the belt.
Capsule endoscopy is used to image the small intestine.
Different endoscopy procedures will have different requirements.
For example, procedures involving the intestine may require laxatives to be taken the night before or enema before the colonoscopy to clear the system.
The patient is kept fasting for 6-12 hours, as needed.
Most of the procedures are daycare procedures. That means it does not require an overnight stay.
Generally, the procedure finishes in less than one hour.
Instructions may vary individually depending on the condition of the patient and coexisting medical issues.
The procedure is performed in a conscious patient though a local anesthetic can be given when needed. The patient may be sedated though.
Uses of Endoscopy
Different procedures including different approaches are individually discussed.
The procedure may be done for investigation [for example to know the cause of gastrointestinal bleeding], confirmation of diagnosis [biopsy of suspected lesion] and treatment [clamp or cauterize bleeding vessel].
Endoscopy is used in surgical resection procedures too. For example, removal of the gall bladder.
The endoscope is known as a laparoscope and the procedure is called laparoscopic. It involves giving a small nick on the abdomen. The laparoscope is also used for removal of the appendix, removal of the uterus and other surgeries that otherwise require the opening of the abdomen.
In orthopedics, endoscopic joint surgery is quite established and is called arthroscopy.
Patient is discharged after the effect of sedation has worn off.
Endoscopy is quite a safe medical procedure. Some patients might feel some problems, most of which are for short period.
Risks also depend on the area that is being examined. Therefore procedure-specific risks and complications are better explained in the specific topics.
Common complications include:
- Cramps or bloating in GI endoscopy
- Persistent pain at the site
- Usually controllable with antibiotics
- Minimal risk now with flexible endoscopes
- May cause internal bleeding
- Complications related to preexisting conditions
- Nausea and vomiting
- Difficulty in swallowing
- Severe irregular heartbeat
- Pulmonary aspiration