What is Endoscopy and why is it so popular

What is Endoscopy?

Get the facts about endoscopy and how it can improve your health. Explore the different types, benefits, and procedure of endoscopy to gain a better understanding of this valuable diagnostic tool.

Endoscopy is a minimally-invasive procedure used to diagnose mucosal disease of the digestive tract, take biopsies as needed and to perform certain interventions. Its popularity stems from the fact that it obviates the need for open surgery and makes treatment simpler. In this article, we will cover a brief history of the procedure, and its use in medicine currently.

Introduction

Open surgery has been around for thousands of years right from ancient civilizations of the world, till date. It carries the risk of bleeding, infection in the area of incision and organ operated upon, collateral damage to tissues in the vicinity of surgery, extended hospitalization, and slow recovery. In certain situations, it’s the only option or the last resort. However, there are innumerable situations when a better alternative to open surgery can be considered.

Minimally-invasive surgeries have fascinated surgeons and doctors throughout history. Right from the 10^th century Arabian physician Abukasim to doctors in Renaissance Europe, there have been many experiments to create instruments for minimally-invasive procedures. Throughout the 19^th century, European physicians such as Bozzini, Desormeaux, Kussmaul and Nitze created various endoscope designs.

The first bronchoscopy (examining lungs) was done in the 1920s and since 1930s, many medical journals in the US and Europe started publishing papers on endoscopy. Since the 1960s, there has been widespread adoption of endoscopy around the world, and from the 1990s, it has become part of mainstream medicine. The name is derived from the latin word ‘endo’ meaning inside, and ‘scope’ – a general term for a viewing instrument.

Uses of Endoscopy

• Investigate symptoms: There are various digestive system disorders that must be investigated for cause. This includes gastrointestinal bleeding, vomiting, difficulty swallowing and abdominal pain. An endoscopy is of big help here.
• Endoscopy is used to ‘biopsy’, or collect tissue samples to be examined under the microscope later. This helps confirm or rule-out certain conditions, and understand their extent. This is used for detecting cancers, inflammation, anemia, and other GI disorders.
• The doctor can slide special tools through the endoscope and treat problems in the digestive system. This includes – cauterizing or burning a blood-vessel to stop bleeding, widening a constricted esophagus, cutting off a polyp (tissue growth) or removing a foreign object.

Benefits of Endoscopy

• Safe: Since these procedures are around for nearly a century, they have been refined and perfected relentlessly, making them reliable for many procedures. There are risks, but these are familiar and well-managed.
• Quick: Since there is no extensive incision, there is no time lost in preparing the patient, anesthesing him/her, and carefully accessing the desired spot. Endoscopies can be as short as 5 minutes or last up to an hour or two at the most in therapeutic instances.
• Painless: The desired spot is accessed through a natural opening in the body. This reduces the area of contact for the endoscope and hence any possible damage. Thereby, pain is reduced.
• Reduced damage: The desired spot is accessed precisely, using good visualization techniques and thin scopes. This reduces collateral damage to tissues in the vicinity.
• Minimum hospitalization: Most endoscopies are outpatient procedures where the patient is discharged the same day.
• Quick recovery: Since specific tissues/organs are targeted, healing is focused and quick.
• Better outcomes: There are many procedures where the endoscopy yields better results than open surgery due to the precision and tools used.

Types of Endoscopy

Arthroscopy – Used when joints are affected. The tube is inserted through a small cut close to the joint.

Bronchoscopy – Used to examine infection or growth in the lungs. The endoscopic tube will be inserted through an opening like the mouth or nose.

Colonoscopy – Used for the examination of your colon or tailbone. The tube will be inserted through the anal cavity.

Cystoscopy – Used to assess damage to the bladder. The scope will be inserted through the urethra.

Enteroscopy – Used when there is a problem with the small intestine. For this, the scope can be introduced through either the mouth or the anus.

Hysteroscopy– Used to check the inside of the uterus in women and the tube is inserted through the vagina.

Laparoscopy – Used to scan your abdominal or pelvic area. A small incision will be made close to the area and the tube will be inserted.

Laryngoscopy – used to inspect the larynx. The camera tube is inserted through the nose or mouth.

Mediastinoscopy – The area between the lungs is called mediastinun and this kind of endoscopy is the examination of that area. A small incision is made above the breastbone for the tube.

Upper gastrointestinal endoscopy – Used to investigate the esophagus and upper intestinal tract. The scope is inserted through the mouth.

Ureteroscopy – Used to check the ureter in men. The tube will be put in through the urethra.

How is Endoscopy done

The endoscope is a thin tube around the width of a pencil made from food-grade plastic or synthetic material that is safe. In most cases, the scope is flexible or bends easily while some lung endoscopies may use a rigid tube. The scope carries a light source and a camera at its end. The light illuminates the insides of the body while the camera relays pictures on to a computer monitor kept inside the OT. The doctor’s movement of the scope is guided by images seen on the screen. The procedure is performed by a specialist called endoscopist.

Smaller tubes called catheters can slide inside the endoscope. Tiny tools can be fixed to the end of the catheter, which helps perform the desired interventions.

Some Routine Endoscopic procedures

Today, there are many advanced therapeutic endoscopies such as PEG, ERCP, etc., done for various reasons. It’s not possible to list out all of them, so we will only cover common or routine endoscopies.

Gastrointestinal (GI) tract or digestive system

• Esophago-gastro-duodenoscopy or EGD: For disorders of the esophagus, stomach, and duodenum
• Enteroscopy: for disorders of the small intestine
• Colonoscopy and Sigmoidoscopy: For disorders of the large intestine or colon

Risks from Endoscopy

There are some risks from an Endoscopic procedure. However, these are minor, familiar to the doctors, and hence easily managed by them.

• Sedation related problems.
• Sore throat after the procedure

When to meet a doctor for endoscopic emergency?

• Vomiting blood
• Stools are black in colour, or fresh bleeding noted
• Foreign body ingestion, accidentally, by children
• Denture ingestion by adults

 

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