What Do I Need to Know About Endoscopy?

In medicine, the term endoscopy can be used in several ways depending on the specific procedure. In general terms, endoscopy refers to a procedure where a medical professional looks inside the body. Endoscopy has come to mean any procedure involving an endoscope, which is a device that combines a small camera, a light source, and a tube that can be maneuvered to various locations in the body. To fit a specific task, the tube can be rigid or flexible, quite long or very short. Endoscopy is a powerful tool that has radically changed the practice of both medicine and surgery. It allows physicians to directly visualize structures inside the body that previously either had to be inferred by X-rays or exposed through open surgery.

 

Perhaps the major advantage that endoscopy provides to surgeons is the chance to avoid open surgery altogether. Since the endoscope can be passed into an area of the body through a very small opening, surgeons are able to see internal structures with such clarity that entire surgeries can be performed through a series of small incisions. This process of using an endoscopy to visualize surgical fields and making only a handful of small incisions is called laparoscopic surgery. Most abdominal surgeries, indeed many surgeries in general, are performed laparoscopically because of the clarity and flexibility of endoscopy. Many joint surgeries are performed with the help of a special endoscope called an arthroscope. Surgical procedures involving the urinary system (bladder, ureters) and reproductive system (cervix, uterus, Fallopian tubes) may involve endoscopy.

Endoscopy has revolutionized the practice of medicine as well. Otolaryngologists have been using a small, rigid endoscope (rhinoscope) that uses lenses instead of a camera to see inside the nose, sinuses and throat. Gastroenterologists (doctors of the digestive system) routinely use endoscopy to see the esophagus, stomach, first part of the small intestine and the colon. GI doctors also use a special endoscopic procedure to diagnose problems of the gallbladder by injecting a dye that can be seen with the help of X-rays. This procedure, called ERCP, can help diagnose a number of diseases of the gallbladder, liver and pancreas unequivocally that could only be inferred or implied otherwise.

Many people wonder what types of anesthesia will be required when having an endoscopy. The answer to that question in most cases depends on the patient and the procedure. If there needs to be an incision made in order to pass the endoscope inside the body, this will almost always involve general anesthesia. In fact most procedures that involve incisions involve general anesthesia. If the endoscopy is purely diagnostic (without a surgery to follow), local anesthesia may be used, which is injected into an area to deaden the pain but the patient is awake the whole time. GI doctors will often use conscious sedation or “twilight anesthesia” for upper endoscopy and colonoscopy. Conscious sedation uses sedatives to deeply relax the patient, but does not require a ventilator which is needed with general anesthesia. Many patients that have an endoscopy with conscious sedation have no memory of the procedure and feel little, if any pain.