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 anesthetized 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

TypeArea examinedWhere scope is insertedDoctors who typically perform the surgery
arthroscopyjointsthrough a small incision near the examined jointorthopedic surgeon
bronchoscopylungsinto the nose or mouthpulmonologist or thoracic surgeon
colonoscopycolonthrough the anusgastroenterologist or proctologist
cystoscopybladderthrough the urethraurologist
enteroscopysmall intestinethrough the mouth or anusgastroenterologist
hysteroscopyinside of the uterusthrough the vaginagynecologists or gynecological surgeons
laparoscopyabdominal or pelvic areathrough a small incision near the examined areavarious types of surgeons
laryngoscopylarynxthrough the mouth or nostrilotolaryngologist, also known as an ear, nose, and throat (ENT) doctor
mediastinoscopymediastinum, the area between the lungsthrough an incision above the breastbonethoracic surgeon
sigmoidoscopya href=”/human-body-maps/rectum”>rectum and the lower part of the large intestine, known as the sigmoid coloninto the anusgastroenterologist or proctologist
thoracoscopy, also known as a pleuroscopythe area between the lungs and the chest wallthrough a small incision in the chesta pulmonologist or thoracic surgeon
upper gastrointestinal endoscopy, also known as an esophagogastroduodenoscopyesophagus and upper intestinal tractthrough the mouthgastroenterologist
ureteroscopyureterthrough the urethraurologist

Medical Uses of Endoscopy

Operation part of the endoscope

Insertion tip of an 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 that 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)

  • esophagus, 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 (proctoscopy) 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 (gyroscope)

  • The cervix (colposcopy)
  • The uterus (hysteroscopy)
  • The fallopian tubes (fluoroscopy)

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

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
  • The 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
  • The 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

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