Endoscopy is the insertion of a long, thin
tube directly into the body to observe an
internal organ or tissue in detail. It can also
be used to carry out other tasks including
imaging and minor surgery.
Endoscopes are minimally invasive and can be inserted into the
openings of the body such as the mouth or anus.
Alternatively, they can be inserted into small incisions, for instance, in
the knee or abdomen. Surgery completed through a small incision
and assisted with special instruments, such as the endoscope, is
called keyhole surgery.
Because modern endoscopy has relatively few risks, delivers detailed
images, and is quick to carry out, it has proven incredibly useful in
many areas of medicine. Today, tens of millions of endoscopies are
carried out each year.
In this article, we will explain some of the types of endoscopy, why
and how they are performed, the general procedure, and any
potential risks.
Fast facts on endoscopy
Here are some key points about endoscopy. More detail and
supporting information is in the main article.
Endoscopies are quick and relatively safe procedures.
The first endoscope was designed in 1806.
The main reasons for endoscopy are investigation,
confirmation, and treatment.
Endoscopy can be used to remove tumors or polyps from the
digestive tract.
Types
Share on PinterestEndoscopy can be useful in a wide array of medical
situations.
Endoscopy is useful for investigating many systems within the human
body; these areas include:
Gastrointestinal tract: esophagus, stomach, and duodenum
(esophagogastroduodenoscopy), small intestine (enteroscopy),
large intestine/colon (colonoscopy, sigmoidoscopy), bile duct,
rectum (rectoscopy), and anus (anoscopy).
Respiratory tract: Nose (rhinoscopy), lower respiratory tract
(bronchoscopy).
Ear: Otoscopy
Urinary tract: Cystoscopy
Female reproductive tract (gynoscopy): Cervix (colposcopy),
uterus (hysteroscopy), fallopian tubes (falloposcopy).
Through a small incision: Abdominal or pelvic cavity
(laparoscopy), interior of a joint (arthroscopy), organs of the
chest (thoracoscopy and mediastinoscopy).
What is a capsule endoscopy?
Capsule endoscopy was developed in the mid-1990s and involves a
wireless camera. The camera is small enough to fit into a capsule
(roughly the size of a vitamin tablet) and can, therefore, be
swallowed.
As the capsule travels through the digestive tract, it takes thousands
of pictures, which are transmitted to a device attached to a wearable
belt.
Capsule endoscopy is used to image the small intestine, a region that
is difficult to image using standard endoscopy. It is also very useful
for examining the small intestinal mucosa and diagnosing Crohn’s
disease. The capsule usually passes through the digestive system
within 24-48 hours.
This is a relatively new technique and was given FDA approval for
use in the United States in 2001. To date, more
than 500,000 capsule endoscopy procedures have been carried out,
and nearly 1,000 articles have been published covering its clinical
use.
Preparation
Share on PinterestAdvice will be provided by a doctor on how to
prepare for an endoscopy, as different procedures will have different
requirements.
The procedure does not require an overnight stay in the hospital and
usually only takes around 1 hour to complete. The doctor will provide
instructions about the preparation for the procedure.
For many types of endoscopy, the individual needs to fast for around
12 hours, though this varies based on the type.
For procedures investigating the gut, laxatives may be taken the
night before to clear the system.
A doctor will carry out an examination before the endoscopy. It is
important to mention all current medications (including supplements)
and any previous procedures.
Procedure
The procedure will depend to some extent on the reason for the
endoscopy.
There are three main reasons for carrying out an endoscopy:
Investigation: If an individual is experiencing vomiting,
abdominal pain, breathing disorders, stomach ulcers, difficulty
swallowing, or gastrointestinal bleeding, for example an
endoscope can be used to search for a cause.
Confirmation of a diagnosis: Endoscopy can be used to carry
out a biopsy to confirm a diagnosis of cancer or other diseases.
Treatment: an endoscope can be used to treat an illness
directly; for instance, endoscopy can be used to cauterize (seal
using heat) a bleeding vessel or remove a polyp.
Sometimes, endoscopy will be combined with another procedure
such as an ultrasound scan. It can be used to place the ultrasound
probe close to organs that can be difficult to image, such as the
pancreas.
Modern endoscopes are sometimes fitted with sensitive lights that
use narrow band imaging. This type of imaging uses specific blue
and green wavelengths that allow the doctor to spot precancerous
conditions more easily.
An endoscopy is typically performed while the patient is
conscious, although sometimes the patient will receive local
anesthetic (commonly an anesthetic spray to the back of the
throat); often, the patient is sedated.
For endoscopy procedures involving entry through the mouth,
a mouth guard will be used to protect the teeth and lips as the tube is
inserted.
Endoscope use in surgery
Share on PinterestEndoscopes used in surgery help minimize bleeding
and recovery times.
Endoscopy has advanced in recent years, enabling some forms of
surgery to be conducted using a modified endoscope; this makes the
surgery less invasive.
Procedures such as the removal of the gallbladder, sealing and tying
the fallopian tubes and the removal of small tumors from the
digestive system or lungs are now commonplace.
A laparoscope is a modified endoscope used for keyhole
surgery (also referred to as laparoscopic surgery).
Laparoscopic surgery requires only a small incision and can be used
for appendectomies (removal of the appendix), hysterectomies
(removal of the uterus) and prostatectomies (removal of prostate
tissue).
Using this technique, patients lose less blood during and after
surgery and can recover much faster compared with standard
surgical procedures.
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Risks and side effects
Endoscopy is a relatively safe procedure, but there are certain risks
involved. Risks depend on the area that is being examined.
Risks of endoscopy may include:
over-sedation, although sedation is not always necessary
feeling bloated for a short time after the procedure
mild cramping
a numb throat for a few hours due to the use of local anesthetic
infection of the area of investigation: this most commonly
occurs when additional procedures are carried out at the same
time. The infections are normally minor and treatable with a
course of antibiotics
persistent pain in the area of the endoscopy
perforation or tear of the lining of the stomach or esophagus
occurs in 1 in every 2,500-11,000 cases
internal bleeding, usually minor and sometimes treatable by
endoscopic cauterization
complications related to preexisting conditions
Any of the following symptoms should be reported to a doctor:
dark colored stool
shortness of breath
severe and persistent abdominal pain
chest pain
vomiting blood
Recovery
Recovery will depend on the type of procedure. For an upper
endoscopy, which is used to enable a doctor to examine the upper
gastrointestinal tract, the patient will be observed for some time after
the procedure, usually around one hour, while any sedative
medication wears off.
The person should not usually work or drive for the rest of the day,
because of the sedative effect of the medication used to prevent the
pain.
There may be some soreness. With this type of endoscopy, there
may be bloating and a sore throat, but these usually resolve quickly.
