It is a procedure in which your doctor uses specialized instruments to observe and support surgical interventions on structures inside the body.
This procedure allows surgeons to view the body’s organs without making large incisions.
A surgeon inserts an endoscope through a small cut or opening in the body, such as the mouth.
An endoscope is a flexible fiberoptic probe with a light source and an attached camera that allows the doctor to notice abnormalities.
The doctor can lean on the endoscope with forceps and scissors to remove tissue for a biopsy.
Usefulness of an endoscopy
Endoscopy is a diagnostic method and can even be used to perform certain surgeries, without having to make a large incision.
A screen in the operating room allows the doctor to reproduce in an image exactly what the endoscope captures, in real time.
Endoscopy is generally used to:
- Determine the cause of any symptoms, allowing a better diagnosis by observing the interior of a specific area of the body.
- Removing small samples of tissue, which can then be sent to a laboratory for pathological testing. This procedure is called an endoscopic biopsy.
- Support surgical procedures, such as repairing stomach ulcers or removing gallstones or tumors.
- Remove foreign bodies, or stop bleeding.
- Give treatments inside the dilated veins of the esophagus in order to stop bleeding.
- Destroy abnormal tissues or clot blood vessels.
An endoscopy may be ordered when symptoms of any of the following conditions occur:
- Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease .
- Stomach ulcers
- Unexplained bleeding in the digestive tract.
- Blockage of the esophagus.
- Disease Gastroesophageal reflux .
- Hernia hiatal.
- Unusual vaginal bleeding
- Blood in the urine.
- Digestive tract problems.
Your doctor will review your symptoms, perform a physical exam, and possibly do some blood tests before an endoscopy.
These tests will help your doctor gain a more accurate understanding of the possible cause of your symptoms.
Most types of endoscopy require fasting, you should stop eating solid foods for up to 12 hours before the procedure and two hours before the procedure you can allow yourself some clear liquids, such as water or some type of juice.
Your doctor may recommend some type of laxative or enema to use the night before the procedure to clean the system.
This is common in procedures that involve the gastrointestinal and anal tracts.
Before endoscopy, the doctor should perform a physical exam and review the patient’s complete medical history, including all previous surgeries.
The doctor should be informed about any allergies and the medications that are being used, especially medications that can affect bleeding, anticoagulants or antiplatelets.
Types of endoscopy
Endoscopes come in different shapes and lengths, each designed to look at different parts of the body.
Most are thin, hollow, flexible tubes that have a light attached to them.
Some also come with a small video camera attached that transmits images to a computer.
Newer versions of endoscopes are small enough to be swallowed and send images wirelessly to a computer.
Endoscopies are classified into categories, based on the area of the body they investigate.
The American Cancer Society (ACS) lists the following types of endoscopies:
- Arthroscopy – Used to examine the joints. It is done through a small incision near the joint being examined.
- Bronchoscopy – Used to examine the trachea and bronchi through the mouth or nose.
- Colonoscopy – Used to examine the colon and large intestine through the anus.
- Cystoscopy – Used to examine the bladder through the urethra.
- Enteroscopy – Used to examine the small intestine through the mouth or anus.
- Gastroscopy or Upper Endoscopy – Used to examine the stomach, esophagus, and duodenum through the mouth with an esophagogastroduodenoscope.
- Hysteroscopy: A hysteroscope is passed through the vagina and through the cervix to examine the uterus.
- Laparoscopy : This is used to examine the organs and tissues of your abdomen and pelvis through an incision in your stomach.
- Laryngoscopy – Used to examine the larynx through the mouth or nose.
- Mediastinoscopy: This is used to examine the space between your lungs through an incision over the breastbone.
- Sigmoidoscopy: This is used to examine your rectum and the lower part of your large colon through the anus.
- Thoracoscopy: This is used to examine the chest cavity and its contents (the lungs and the lining of the lungs) through an incision in the chest.
- Ureteroscopy – Used to examine the ureter.
The latest techniques in endoscopic technology, like most technologies, are constantly advancing. Newer generations of endoscopes use high definition imaging to create images with incredible detail.
Innovative techniques also combine endoscopy with imaging technology or surgical procedures.
Here are some of the latest endoscopy technologies:
A revolutionary procedure known as a capsule endoscopy can be used when other evidence is inconclusive.
During this procedure, a small pill with a small chamber inside is swallowed.
The capsule passes through your digestive tract, without any discomfort to you, and creates thousands of images of the intestines as it goes.
Endoscopic retrograde cholangiopancreatography
This procedure is a combination of X-rays with digestive endoscopy for the diagnosis or treatment of conditions of the bile and pancreatic ducts.
Chromoendoscopy is a technique that uses a specialized stain or dye on the lining of the intestine during an endoscopy procedure.
The dye helps the doctor better see if there is something abnormal in the intestinal lining.
Endoscopic ultrasound uses an ultrasound in conjunction with an endoscopy.
This allows doctors to see organs and other structures that are not usually visible during a regular endoscopy.
A fine needle can then be inserted into the organ or framework to retrieve some tissue for viewing under a microscope.
Endoscopic resection of the mucosa
This is a technique used to help doctors eliminate cancerous tissue in the digestive tract.
In endoscopic mucosal resection, a needle is passed through the endoscope to inject fluid under the abnormal tissue.
This helps separate the cancerous tissue from the other layers so that it can be more easily removed.
Narrow band image
To perform this procedure, a special filter is used to help create more contrast between the vessels and the mucosa.
The mucosa is the inner lining of the digestive tract.
Endoscopy has a much lower risk of bleeding and infection than open surgery.
Endoscopy can produce effects, but most are related to medications used for sedation.
On the other hand, endoscopy is a medical procedure, so it poses a certain risk of bleeding, infection and other rare complications, such as:
- Chest pain.
- Organ damage, including possible perforation.
- Persistent pain in the endoscopy area.
- Redness and swelling at the incision site.
The risks for each type depend on the location of the procedure and the patient’s own condition.
For example, dark-colored stools, vomiting, and difficulty swallowing after a colonoscopy could indicate that something is wrong.
A hysteroscopy carries a small risk of uterine perforation, uterine bleeding, or cervical trauma.
In the procedure where the endoscopic capsule is used, there is a risk that the capsule will not follow its normal course in the digestive tract, becoming stuck.
The risk is higher for people with a condition that causes a narrowing of the digestive tract, such as a tumor. The capsule may need to be surgically removed.
Most endoscopies are outpatient procedures. The doctor will close the incision wounds with stitches immediately after the procedure and will give instructions on how to care for this wound for good healing. Some procedures can leave a bit of discomfort.
After an upper endoscopy , there may be a possibility of a sore throat and soft food may be required for a couple of days.
You may have blood in your urine after a cystoscopy to examine your bladder.