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An endoscopy is a procedure used in
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
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 endoscopies. Depending on the site in the body and type of procedure, an endoscopy may be performed by either 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. For nonmedical use, similar instruments are called
borescope A borescope (occasionally called a boroscope, though this spelling is nonstandard) is an optical instrument designed to assist visual inspection of narrow, difficult-to-reach cavities, consisting of a rigid or flexible tube with an eyepiece or d ...
s.


History

Adolf Kussmaul was fascinated by sword swallowers who would insert a sword down their throat without gagging. This drew inspiration to insert a camera, the next problem to solve was how to insert a source of light, as they were still relying on candles and oil lamps. The term ''endoscope'' was first used on February 7, 1855, by engineer-optician Charles Chevalier, in reference to the ''uréthroscope'' of Désormeaux, who himself began using the former term a month later. The self-illuminated endoscope was developed at Glasgow Royal Infirmary in
Scotland Scotland (, ) is a country that is part of the United Kingdom. Covering the northern third of the island of Great Britain, mainland Scotland has a border with England to the southeast and is otherwise surrounded by the Atlantic Ocean to ...
(one of the first hospitals to have mains electricity) in 1894/5 by Dr John Macintyre as part of his specialization in the investigation of the larynx.


Medical uses

Endoscopy may be used to investigate symptoms in the digestive system including
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of th ...
, vomiting,
abdominal pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. About 15% of people have a m ...
, difficulty swallowing, and gastrointestinal bleeding. It is also used in diagnosis, most commonly by performing a biopsy to check for conditions such as anemia, bleeding, inflammation, and cancers of the digestive system. The procedure may also be used for treatment such as
cauterization Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or ...
of a bleeding vessel, widening a narrow esophagus, clipping off a polyp or removing a foreign object. Specialty
professional organizations A professional association (also called a professional body, professional organization, or professional society) usually seeks to further a particular profession, the interests of individuals and organisations engaged in that profession, and the ...
that specialize in digestive problems advise that many patients with
Barrett's esophagus Barrett's esophagus is a condition in which there is an abnormal ( metaplastic) change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cells ...
receive endoscopies too frequently. 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

Health care providers can use endoscopy to review any of the following body parts: * The gastrointestinal tract (GI tract): **
oesophagus The esophagus ( American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to ...
, stomach and duodenum ( esophagogastroduodenoscopy) ** small intestine ( enteroscopy) ** large intestine/ colon ( colonoscopy, sigmoidoscopy) ** Magnification endoscopy **
bile duct A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic 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 A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passe ...
(
rhinoscopy A Rhinoscope (or Nasoscope) is a thin, tube-like instrument used to examine the inside of the nose. A rhinoscope has a light and a lens for viewing and may have a tool to remove tissue. Types Rhinoscopy is performed by two procedures. * Anterio ...
) ** The upper respiratory tract (
laryngoscopy Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation durin ...
) ** The lower respiratory tract ( bronchoscopy) * The ear ( otoscope) * The urinary tract ( cystoscopy) * The female
reproductive system The reproductive system of an organism, also known as the genital system, is the biological system made up of all the anatomical organs involved in sexual reproduction. Many non-living substances such as fluids, hormones, and pheromones are ...
(gynoscopy) ** The cervix ( colposcopy) ** The
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
( 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 Thoracoscopy is a medical procedure involving internal examination, biopsy and/or resection/drainage of disease or masses within the pleural cavity, usually with video assistance. Thoracoscopy may be performed either under general anaesthesia o ...
and mediastinoscopy) Endoscopy is used for many procedures: * During
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ...
** The amnion (amnioscopy) ** The fetus ( fetoscopy) * Plastic surgery * Panendoscopy (or triple endoscopy) ** Combines
laryngoscopy Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation durin ...
, esophagoscopy, and bronchoscopy * Orthopedic surgery ** Hand surgery, such as
endoscopic carpal tunnel release Endoscopic carpal tunnel release (ECTR) refers to a method of performing carpal tunnel surgery using an endoscope or an Arthroscopy, arthroscopic device to provide visualization of the anatomic structures. Endoscopic techniques for carpal tunne ...
**
Knee surgery In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in ...
, such as
anterior cruciate ligament reconstruction Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from ...
** Epidural space (Epiduroscopy) ** Bursae ( Bursectomy) * Endodontic surgery ** Maxillary sinus surgery ** Apicoectomy * Endoscopic endonasal surgery *
Endoscopic spinal surgery Minimally invasive spine surgery, also known as MISS, has no specific meaning or definition. It implies a lack of severe surgical invasion. The older style of open-spine surgery for a relatively small disc problem used to require a 5-6 inch incisio ...
An endoscopy is a simple procedure that allows a doctor to look inside human bodies using an instrument called an endoscope. A cutting tool can be attached to the end of the endoscope, and the apparatus can then be used to perform minor procedures such as tissue biopsies, banding of oesophageal varices or removal of polyps.


Application in other fields

* For non-medical use, such as internal inspection of complex technical systems,
borescope A borescope (occasionally called a boroscope, though this spelling is nonstandard) is an optical instrument designed to assist visual inspection of narrow, difficult-to-reach cavities, consisting of a rigid or flexible tube with an eyepiece or d ...
s are used. These are similar to endoscopes. * The planning and architectural community use
architectural endoscopy Architectural endoscopy or architectural envisioning is used to photograph and film models of new buildings' exterior and interior in the planning stage. An architectural model of a new building in a 1:500 scale is thus correctly visualized from the ...
for pre-visualization of scale models of proposed buildings and cities * Endoscopes are also a tool helpful in the examination of improvised explosive devices by
bomb disposal Bomb disposal is an explosives engineering profession using the process by which hazardous explosive devices are rendered safe. ''Bomb disposal'' is an all-encompassing term to describe the separate, but interrelated functions in the milit ...
personnel. * Law enforcement uses endoscopes for conducting surveillance via tight spaces.


Risks

The main risks are infection, over-sedation, perforation, or a tear of the stomach or esophagus lining and bleeding. Although perforation generally requires surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of a biopsy or polyp removal. Such typically minor bleeding may simply stop on its own or be controlled by cauterisation. Seldom does surgery become necessary. Perforation and bleeding are rare during gastroscopy. Other minor risks include drug reactions and complications related to other diseases the patient may have. Consequently, patients should inform their doctor of all allergic tendencies and medical problems. Occasionally, the site of the sedative injection may become inflamed and tender for a short time. This is usually not serious and warm compresses for a few days are usually helpful. While any of these complications may possibly occur, each of them occurs quite infrequently. A doctor can further discuss risks with the patient with regard to the particular need for gastroscopy.


After the endoscopy

After the procedure, the patient will be observed and monitored by a qualified individual in the endoscopy room, or a recovery area, until a significant portion of the medication has worn off. Occasionally the patient is left with a mild sore throat, which may respond to saline gargles, or chamomile tea. It may last for weeks or not happen at all. The patient may have a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered, the patient will be instructed when to resume their usual diet (probably within a few hours) and will be allowed to be taken home. Where sedation has been used, most facilities mandate that the patient be taken home by another person and that they not drive or handle machinery for the remainder of the day. Patients who have had an endoscopy without sedation are able to leave unassisted.


See also

* Endoscope * Colonoscopy * Enteroscopy *
Surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...
* Anesthesia


References


External links


The Atlas of Gastrointestinal Endoscopy
endoatlas.com



* ttps://web.archive.org/web/20110513090434/http://www.massdevice.com/blogs/massdevice/preventing-cross-contamination-flexible-endoscopes Preventing cross-contamination from flexible endoscopesmassdevice.com
Advances in Endoscopy
advancedimagingpro.com {{Authority control Diagnostic gastroenterology