Endoscopy
What is endoscopy?
Endoscopy is a procedure in which a doctor looks down a thin lighted tube inserted into the body to see the internal structures of the body and search for disease. The instrument used for this procedure is called an endoscope. In some cases, the endoscope can also be used to treat disease, for example, when fitted with a small electric probe it can be used to destroy areas of abnormal tissue.
The tube may be rigid or flexible with fibre optic equipment and a tiny camera attached to the end for transmitting pictures.
Different types of endoscopy
Individual endoscopes have been developed for different parts of the body. Examples of investigations that pass an endoscope through a natural opening, such as the mouth or anus, to diagnose/view various conditions include the following.
- Gastroscopy — viewing of the stomach and oesophagus. Used to check for ulcers, bleeding or tumours.
- Colonoscopy and sigmoidoscopy — viewing of the colon. Used to check for tumours or polyps (small growths) and other bowel conditions.
- Bronchoscopy — viewing of the airways and lung tissue. Used to remove foreign bodies, take samples to diagnose lung cancer or other lung diseases and to assess the condition of the airways following smoke inhalation.
- Cystoscopy — viewing of the bladder. Used to check for tumours, stones and other abnormalities.
- Hysteroscopy — viewing of the uterus. Used to check for adhesions or polyps and to investigate excessive menstrual bleeding.
In other types of endoscopy, the skin is opened to allow the scope to enter an area.
- Arthroscopy — to look into a joint such as the knee. Used to check for torn ligaments or damaged cartilage.
- Laparoscopy — to look into the abdomen. Used to check for gynaecological conditions, damage from injury and conditions affecting any of the abdominal organs.
A newer type of endoscopy has been developed in which you swallow a device that is the size of a large vitamin pill and has no external wires or cables. This ‘capsule endoscope’ is equipped with a camera and sends pictures to a recorder worn externally in a harness on your waist — these images are evaluated by your doctor. The capsule is disposable and is excreted naturally in your stool. The test does not normally cause discomfort and requires no sedation. It can be useful to look for problems in the small bowel, which is difficult to visualise in other ways.
Other uses of endoscopy
Apart from helping doctors to make a diagnosis, endoscopy is also used to treat a number of conditions. Rectal or colonic polyp removal, transurethral resection of the prostate (TURP), knee joint surgery, and some types of gallbladder removal are just a few of the operations that use endoscopy.
Some endoscopes have attachments that can be used to cut off pieces of tissue which are then analysed in a laboratory (this process is called a biopsy), or to pass an electric current to seal off a point of tissue that is bleeding (electrocautery).
Endoscopy procedures
As endoscopy procedures give a direct view of the organ concerned, either through a natural opening or through a small incision in the skin, they can save patients from complicated investigations, and from major exploratory surgery that involves a large opening in the skin and underlying tissues.
When preparing for most types of endoscopy, fasting is usually recommended before the procedure. Check with the clinic or hospital performing your endoscopy regarding how long you should fast for, whether you can drink fluids during this time and what to do about any medicines you are taking. If you have diabetes and use insulin, talk to your doctor about how to alter your insulin regimen to account for the fasting period. If you have heart valve disease, you will need antibiotics before some types of endoscopy.
Some types of endoscopy require more extensive preparation. Before a colonoscopy, for example, you will need to take a special solution to clean out the bowel. The hospital or clinic performing the procedure will be able to advise you on this.
You will generally be admitted to hospital for endoscopy. For simple procedures you are likely to go home the same day, while more complicated procedures may require an overnight stay.
Anaesthetic
Depending on the part of the body being viewed, either local or general anaesthetic is used. You may be sedated before the procedure.
The endoscope is passed carefully into the opening and the view from the camera is relayed to a screen for the doctor, and sometimes the patient, to see. A biopsy may be performed at this time, or repairs made, or diseased parts removed. The endoscope is then removed and if an incision has been made, it will be closed and dressed, although stitches may not be needed for a small incision.
Mild pain-relieving medicines may be prescribed for some procedures.
Are there complications and risks?
Complications from endoscopy are rare. Puncture of or damage to the organ being examined is possible, but more common complications are a small amount of bleeding (especially if a biopsy is taken) and slight irritation of the lining of the organ being examined.
Last Reviewed: 02 December 2009
- 1. Gastroenterological Society of Australia (GESA) [website]. Colonoscopy (updated 2003, April). Available at: http://www.gesa.org.au/leaflets/colonoscopy.cfm (accessed 2009, Dec 3)
2. Gastroenterological Society of Australia (GESA) [website]. Upper endoscopy (gastroscopy) (2007, August). Available at: http://www.gesa.org.au/leaflets/upper-endoscopy.cfm (accessed 2009, Dec 4)
3. Gastroenterological Society of Australia (GESA) [website]. Capsule endoscopy (2007, August). Available at: http://www.gesa.org.au/leaflets/capsule_endoscopy.cfm (accessed 2009, Dec 4)
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