Endoscopy; Defination, Types, Medical Uses / Indications, Procedure, Complications

Endoscopy
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Endoscopy (looking inside) is used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.

There are many types of endoscopes. Depending on the site in the body and type of procedure an endoscopy may be performed either by a doctor or a surgeon. A patient may be fully conscious or anaesthetised during the procedure. Most often the term endoscopy is used to refer to an examination of the upper part of the gastrointestinal tract, known as an esophagogastroduodenoscopy.

Types of Endoscopy

Endoscopies fall into categories, based on the area of the body that they investigate. The American Cancer Society (ACS) lists the following types of endoscopies

Type Area examined Where scope is inserted Doctors who typically perform the surgery
arthroscopy joints through a small incision near the examined joint orthopedic surgeon
bronchoscopy lungs into the nose or mouth pulmonologist or thoracic surgeon
colonoscopy colon through the anus gastroenterologist or proctologist
cystoscopy bladder through the urethra urologist
enteroscopy small intestine through the mouth or anus gastroenterologist
hysteroscopy inside of the uterus through the vagina gynecologists or gynecological surgeons
laparoscopy abdominal or pelvic area through a small incision near the examined area various types of surgeons
laryngoscopy larynx through the mouth or nostril otolaryngologist, also known as an ear, nose, and throat (ENT) doctor
mediastinoscopy mediastinum, the area between the lungs through an incision above the breastbone thoracic surgeon
sigmoidoscopy a href=”/human-body-maps/rectum”>rectum and the lower part of the large intestine, known as the sigmoid colon into the anus gastroenterologistor proctologist
thoracoscopy, also known as a pleuroscopy area between the lungs and the chest wall through a small incision in the chest pulmonologist or thoracic surgeon
upper gastrointestinal endoscopy, also known as an esophagogastroduodenoscopy esophagus and upper intestinal tract through the mouth gastroenterologist
ureteroscopy ureter through the urethra urologist
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Medical uses of Endoscopy

Operation part of the endoscope

Insertion tip of endoscope

A health care provider may use endoscopy for any of the following:

  • investigation of symptoms, such as symptoms in the digestive system including nausea, vomiting, abdominal paindifficulty swallowing, and gastrointestinal bleeding.
  • confirmation of a diagnosis, most commonly by performing a biopsy to check for conditions such as anemia, bleeding, inflammation, and cancers of the digestive system.
  • giving treatment, such as cauterization of a bleeding vessel, widening a narrow esophagus, clipping off a polyp or removing a foreign object.

Specialty professional organizations which specialize in digestive problems advise that many patients with Barrett’s esophagus are too frequently receiving endoscopies. Such societies recommend that patients with Barrett’s esophagus and no cancer symptoms after two biopsies receive biopsies as indicated and no more often than the recommended rate.

Applications of Endoscopy

An anoscope, a proctoscope, and a rectoscope with approximate lengths

Endoscopy surgery

Health care providers can use endoscopy to review any of the following body parts:

The gastrointestinal tract (GI tract)

  • oesophagus, stomach and duodenum (esophagogastroduodenoscopy)
  • small intestine (enteroscopy)
  • large intestine/colon (colonoscopy, sigmoidoscopy)
  • Magnification endoscopy
  • bile duct – endoscopic retrograde cholangiopancreatography (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy
  • rectum (rectoscopy) and anus (anoscopy), both also referred to as (proctoscopy)

The respiratory tract

  • The nose (rhinoscopy)
  • The lower respiratory tract (bronchoscopy)
  • The ear (otoscope)
  • The urinary tract (cystoscopy)

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)

Endoscopy is used for many procedures

During pregnancy

  • The amnion (amnioscopy)
  • The fetus (fetoscopy)
  • Plastic surgery
  • Panendoscopy (or triple endoscopy)
    • Combines laryngoscopy, esophagoscopy, and bronchoscopy

Orthopedic surgery

  • Hand surgery, such as endoscopic carpal tunnel release
  • Knee surgery, such as anterior cruciate ligament reconstruction
  • Epidural space (Epiduroscopy)
  • Bursae (Bursectomy)

Endodontic surgery

  • Maxillary sinus surgery
  • Apicoectomy
  • Endoscopic endonasal surgery
  • Endoscopic spinal surgery
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Risk of gastrointestinal endoscopy

  • Upper GI endoscopy (EGD): Although rare, bleeding and puncture of your esophagus or stomach walls are possible during EGD. Other complications include the following
  • Severe irregular heartbeat
  • Pulmonary aspiration – When material, either particulate (food, foreign body) or fluid (gastric contents, blood, or saliva), enters from your throat into your windpipe
  • Infections and fever that wax and wain
  • Respiratory depression, a decrease in the rate or depth of breathing, in people with severe lung diseases or liver cirrhosis
  • Reaction of the vagus nerve system to the sedatives
  • Lower GI endoscopy (colonoscopy, sigmoidoscopy, enteroscopy): Although uncommon, possible complications of colonoscopy and sigmoidoscopy include the following:
  • Local pain
  • Dehydration (due to excess of laxatives and enemas for bowel preparation)
  • Cardiac arrhythmias
  • Bleeding and infection in the bowel, usually after a biopsy or removal of a polyp.
  • Perforation or hole in the bowel wall
  • Explosion of combustible gases in the colon (certain gases are produced within the bowel) during removal of polyps
  • Respiratory depression usually due to oversedation in people with chronic lung disease

References

  1.  “Endoscopy”. Cancer Research UK. Retrieved 5 November 2015.
  2. “The Scottish Society of the History of Medicine” (PDF).
  3. Staff (2012). “Upper endoscopy”Mayo Clinic. Retrieved 24 September 2012.
  4. American Gastroenterological Association“Five Things Physicians and Patients Should Question” (PDF), Choosing Wisely: an initiative of the ABIM FoundationAmerican Gastroenterological Association, archived from the original (PDF) on August 9, 2012, retrieved August 17, 2012
  5. Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (March 2011). “American Gastroenterological Association medical position statement on the management of Barrett’s esophagus”. Gastroenterology140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030PMID 21376940.
  6. Wang KK, Sampliner RE (March 2008). “Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus”. The American Journal of Gastroenterology103 (3): 788–97. doi:10.1111/j.1572-0241.2008.01835.xPMID 18341497.
  7. “Endoscopy”NHS Choices. NHS Gov.UK. Retrieved April 20, 2017.
  8.  Bozzini, Philipp (1806). “Lichtleiter, eine Erfindung zur Anschauung innerer Teile und Krankheiten, nebst der Abbildung” [Light conductor, an invention for examining internal parts and diseases, together with illustrations]. Journal der practischen Arzneykunde und Wundarzneykunst (in German). 24: 107–24.
  9. Yamada T (2009-01-22). Atlas of Gastroenterology. John Wiley & Sons. ISBN 978-1-4443-0342-1.
  10. Caniggia A, Nuti R, Lore F, Martini G, Turchetti V, Righi G (April 1990). “Long-term treatment with calcitriol in postmenopausal osteoporosis”Metabolism39 (4 Suppl 1): 43–9. doi:10.1136/bmj.1.223.345JSTOR 25204557PMC 2325571.
  11. Shawki O, Deshmukh S, Pacheco LA (2017). Mastering the Techniques in Hysteroscopy. Jaypee Brothers Medical Publishers. pp. 13–. ISBN 978-93-86150-49-3.
  12. Litynski GS (1997). “Laparoscopy–the early attempts: spotlighting Georg Kelling and Hans Christian Jacobaeus”Jsls1 (1): 83–5. PMC 3015224PMID 9876654.
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