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ENDOSCOPY
Dr. Tayyba Kiran
Lecturer (IIHS)
ISLAMABAD
HISTORY OF ENDOSCOPY
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The word endoscopy is derived from the Greek words
"Endo" meaning "inside" and "skopeein" meaning "to
see". It is a word used in medicine to describe the
procedure used see inside various parts of the body.
Historically, it was known that it is possible to insert
tubes into body orifices, but to see clearly a method was
needed to illuminate the inside of the organ to be seen.
The earliest crude attempts used oil lamps, which were
later replaced by small electric filament bulbs. These
were not very bright and tended to produce a lot of heat.
Science of Endoscopy
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Medical endoscopy really came into its own after the
invention and application of fibre-optic technology to
endoscopy.
Fibre-optic endoscopes use bundles of thin glass fibres to
transmit light to and from the organ being viewed. These
fibres use the principle of total internal reflection to
transmit almost 100 % of the light entering one end to the
other end.
ENDOSCOPY
Endoscopy, is the
examination of internal
body cavities using a
specialized medical
instrument called an
endoscope.
Physicians use endoscopy
to diagnose, monitor,
and surgically treat
various medical
problems.
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EQUIPMENT
COMPONENTS
An endoscope is a slender,
flexible tube equipped with
lenses and a light source.
Illumination is done by the
help of a number of optical
fibres.
Reflected light rays are
collected by CCD( Charge
coupled device) and electrical
signals are produced, which
are fed to the video monitor
to get image.
Thorough one channel of
endoscope water and air is
conducted to wash and dry
the surgical site. 5
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ENDOSCOPY AND
IT’S PROCEDURE
The endoscope also has a
channel through which surgeons
can manipulate tiny instruments,
such as forceps, surgical
scissors, and suction devices.
A variety of instruments can be
fitted to the endoscope for
different purposes.
A surgeon introduces the
endoscope into the body either
through a body opening, such as
the mouth or the anus, or
through a small incision in the
skin.
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How Do I Prepare for Endoscopy?
Gut Preparation. Examining the upper
digestive tract (upper endoscopy or ERCP)
requires nothing more than fasting for 6-8
hours prior to the procedure.
To examine the colon, it must be cleared of
stool. Therefore, a laxative or group
of laxatives is given on the day before the
procedure.
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Sedation. For most examinations with an
endoscope, a sedative is provided. This increases
the comfort of the individual undergoing the
examination. The sedative, which is administered
via an injection into the vein, produces relaxation
and light sleep.
There are usually few if any recollections of the
procedure. Patients wake up within an hour, but
the effects of the medicines are more prolonged,
so it is not safe to drive until the next day.
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Capsule endoscopy
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Scientists recently devised a disposable
flash camera only slightly larger than a
vitamin pill.
In a procedure called capsule endoscopy,
the patient swallows the minicam, which
then takes pictures inside the small
intestine.
On its journey through the digestive tract,
the tiny tumbling camera transmits images
that are stored in a recorder that the
person wears around the waist. After 8
hours, the camera's battery runs out, and
the capsule is eliminated in the faeces.
Scientists then download the recorder's
images into a computer.
USES OF The endoscope
ENDOSCOPY gives visual
evidence of the
problem, such as
ulceration or
inflammation
It can be used to
collect a sample of
tissue; remove
problematic
tissue, such as
polyps
It is used to take
photograph of the
hollow internal
organs
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Uses of endoscopy:
Stomach pain
Ulcers, gastritis, or difficulty swallowing
Digestive tract bleeding
Changes in bowel habits (chronic
constipation or diarrhea)
Polyps or growths in the colon
In addition, your doctor may use an endoscope
to take a biopsy(removal of tissue) to look for
the presence of disease.
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Endoscopy may also be used to treat a digestive tract
problem. For example, the endoscope might not only detect
active bleeding from an ulcer, but devices can be passed
through the endoscope that can stop the bleeding. In the
colon, polyps can be removed through the scope to prevent
the development of colon cancer.
Also, using ERCP, gallstones that have passed outside the
gallbladder and into the bile duct can often be removed.
ERCP is special form of endoscopy called endoscopic
retrograde cholangiopancreaticography, or ERCP, allows
pictures of the pancreas,gallbladder, and related structures
to be taken
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List of the major types of endoscopy
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GASTROSCOPY: To see the gullet, stomach and upper small intestine.
COLONOSCOPY: To see the large intestine.
LAPAROSCOPY: To see the "stomach cavity" and the organs therein like
uterus, fallopian tube.
PROCTOSCOPY: This is used to check for piles and other conditions of
the anus and rectum. The picture on the right illustrates this.
CYSTOSCOPY: To see the urinary bladder.
BRONCHOSCOPY: To see the air passages to the lungs.
LARYNGOSCOPY: To see the larynx or voice box.
NASOPHARYNGOSCOPY: To see the nose and related cavities.
ARTHROSCOPY: To see inside joints such as the knee joint.
THORACOSCOPY: To see inside the chest cavity.
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The gastrointestinal tract (GI tract):
esophagus, stomach and duodenum (esophagogastroduoden
oscopy)
small intestine (enteroscopy)
large intestine/colon (colonoscopy, sigmoidoscopy)
Magnification endoscopy
bile duct
endoscopic
retrogradecholangiopancreatography (ERCP),
duodenoscope-assisted cholangiopancreatoscopy,
intraoperative cholangioscopy
rectum (rectoscopy) and anus (anoscopy), both also
referred to as (proctoscopy)
The respiratory tract
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The nose (rhinoscopy)
The lower respiratory tract (bronchoscopy)
The ear (otoscope)
The urinary tract (cystoscopy)
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The female reproductive system (gynoscopy)
The cervix (colposcopy)
The uterus (hysteroscopy)
The fallopian tubes (falloposcopy)
Normally closed body cavities (through a small incision):
The abdominal or pelvic cavity (laparoscopy)
The interior of a joint (arthroscopy)
Organs of the chest
(thoracoscopy and mediastinoscopy)
Complications:
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Overall, endoscopy is very safe; however, the
procedure does have a few potential complications,
which may include:
Perforation (tear in the gut wall)
Reaction to sedation
Infection
Bleeding
Pancreatitis as a result of ERCP
Limitations of Endoscopy
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Compared with other parts of the digestive tract, the
small intestine is difficult for doctors to access.
While a camera-tipped tube slipped down the throat can
get images of the stomach and a tube inserted at the other
end of the tract reveals the large intestine, no such device
reaches into most of the small intestine.
So, doctors rely on externally generated images
Thank you
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