Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an instrument called an endoscope. Endoscopy can also refer to using a borescope in technical situations where direct line-of-sight observation is not feasible.
Endoscopy is a minimally invasive diagnostic medical procedure
that is used to assess the interior surfaces of an organ by inserting a tube into the body. The instrument may have a rigid or flexible tube and not only provide an image for visual
inspection and photography
, but also enable taking biopsies and retrieval of foreign objects. Endoscopy is the vehicle for minimally invasive surgery
, and patients may receive conscious sedation
so they do not have to be consciously aware of the discomfort.
Many endoscopic procedures are considered to be relatively painless and, at worst, associated with mild discomfort; for example, in esophagogastroduodenoscopy, most patients tolerate the procedure with only topical anaesthesia of the oropharynx using lignocaine spray. Complications are not common (only 5% of all operations) but can include perforation of the organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery may be required to repair the injury.
An endoscope can consist of
- a rigid or flexible tube
- a light delivery system to illuminate the organ or object under inspection. The light source is normally outside the body and the light is typically directed via an optical fiber system
- a lens system transmitting the image to the viewer from the fiberscope
- an additional channel to allow entry of medical instruments or manipulators
Endoscopy can involve
The first endoscope, of a kind, was developed in 1806 by Philip Bozzini
with his introduction of a "Lichtleiter" (light conductor) "for the examinations of the canals and cavities of the human body". However, the Vienna Medical Society
disapproved of such curiosity. An endoscope was first introduced into a human in 1822 by William Beaumont, an army surgeon at Mackinac Island, Michigan
. The use of electric light was a major step in the improvement of endoscopy. The first such lights were external. Later, smaller bulbs became available making internal light possible, for instance in a hysteroscope
by Charles David
in 1908. Hans Christian Jacobaeus
has been given credit for early endoscopic explorations of the abdomen and the thorax with laparoscopy
(1912) and thoracoscopy
(1910). Laparoscopy was used in the diagnosis of liver
disease by Heinz Kalk
in the 1930s. Hope reported in 1937 on the use of laparoscopy to diagnose ectopic pregnancy
. In 1944, Raoul Palmer placed his patients in the Trendelenburg position
after gaseous distention of the abdomen and thus was able to reliably perform gynecologic
laparoscopy. In the early 1950s Harold Hopkins
designed a “fibroscope” (a flexible bundle of glass fibres), which proved useful both medically and industrially, paving the way for modern fibre optic cables. Hopkins refined his ideas with a German manufacturer, resulting in a design breakthrough in 1967 which enabled surgeons to view and photograph inaccessible areas of the body in detail.
- Punctured organs
- Allergic reactions due to Contrast agents or dyes (such as those used in a CT scan)
After the endoscopy
After the procedure the patient will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or 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 his/her usual diet (probably within a few hours) and will be allowed to be taken home. Because of the use of sedation, most facilities mandate that the patient is taken home by another person and not to drive on his/her own or handle machinery for the remainder of the day.
With the application of robotic systems, telesurgery was introduced as the surgeon could operate from a site physically removed from the patient. The first transatlantic surgery has been called the Lindbergh Operation
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- Armin Gärtner; medical technics and information technologie, Band II. Medizintechnik und Informationstechnologie, Band II. ISBN 3-8249-0941-3.
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