Endoscopic Techniques
Endoscopy is a procedure that allows the doctor to view the inside of a person's body. An endoscope is a thin, lighted flexible tube with a camera or video camera at the end. It helps the doctor see a specific part of the body to diagnose diseases and find problems, such as ulcers, polyps, or tumors. In addition to their use in diagnosis, endoscopes are used to treat some problems. For example, doctors can use an endoscope to remove colon polyps during a colonoscopy (see below) or to perform surgeries through small incisions in the skin, called laparoscopic surgery [1]. These types of procedures are done by inserting another tube with a tool at the end through a channel in the endoscope. Doctors may also use the endoscope to give laser therapy, photodynamic therapy, or drugs.
Some of the tools a doctor may use include:
- Flexible forceps for taking a tissue sample
- Biopsy forceps for taking a tissue sample or removing a suspicious growth, such as a polyp in the colon
- Cytology brush for taking cell samples
- Suture removal forceps for removing stitches inside the body
Advances in technology have helped make endoscopes thinner and more flexible, allowing doctors to see parts of the body that were once unreachable with earlier tools and making the procedures more comfortable for the patient. Originally, endoscopy was only used on the upper gastrointestinal tract (esophagus and stomach) and lower gastrointestinal tract (colon and sigmoid colon). Currently, diseases of the ear, nose, and throat, as well as the heart, urinary tract, joints, and abdomen can be diagnosed and sometimes treated by using these tools.
Different types of endoscopes are used depending on which part of the body needs to be viewed. These vary in length and flexibility. For example, an endoscope for arthroscopy (a procedure to examine joints) may be quite rigid, whereas one for viewing the colon is flexible.
The following are some of the most common types of endoscopy.
| Name of procedure | Name of tool | Area or organ viewed | How endoscope reaches target area |
| Arthroscopy | Arthroscope | Joints | Inserted through a small incision over the area to be viewed |
| Bronchoscopy | Bronchoscope | Trachea and bronchi of the lungs | Inserted through the mouth |
| Colonoscopy | Colonoscope | Entire length of the colon and large intestine | Inserted through the anus |
| Colposcopy | Colposcope | Vagina and cervix | Used to view the vagina and the cervix from outside the body |
| Cystoscopy | Cystoscope | Inside of the bladder | Inserted through the urethra |
| Esophagoscopy | Esophagoscope | Esophagus | Inserted through the mouth |
| Gastroscopy | Gastroscope | Stomach and duodenum (beginning of the small intestine) | Inserted through the mouth |
| Laparoscopy | Laparoscope | Stomach, liver, other abdominal organs, including female reproductive organs (uterus, ovaries, fallopian tubes) | Inserted through a small, surgical opening in the abdomen |
| Laryngoscopy | Laryngoscope | Larynx (voice box) | Inserted through the mouth |
| Neuroendoscopy | Neuroendoscope | Areas of the brain | Inserted through a small incision in the skull near the area to be viewed |
| Proctoscopy | Proctoscope | Rectum and sigmoid colon | Inserted through the anus |
| Sigmoidoscopy | Sigmoidoscope | Sigmoid colon (bottom part of the colon) | Inserted through the anus |
| Thoracoscopy | Thoracoscope | Pleura covering the lungs and structures covering the heart | Inserted through a small surgical opening in chest |
Endoscopy can be done with local, general, or no anesthesia, depending upon the type of endoscopy. It can often be done on an outpatient basis, meaning there is no need for an overnight hospital stay.
Doctors performing endoscopy go through extensive training to learn the procedures, and they participate in continuing education to learn about new developments in technology.
Side effects and complications from endoscopy are not common, but they can happen. The most common complication is a puncture in the area being examined. Bleeding may also occur. Infections can occur from these procedures if bacteria get into the body. However, it is generally agreed that the benefits of endoscopy far outweigh the risks.
In addition to the types of endoscopy mentioned in the table above, virtual colonoscopy is a relatively new tool that is not a true endoscopic technique. Virtual colonoscopy uses computed tomography (CT) scans [2] of thin segments of the colon that are joined together by a computer to create a view of the inside of the colon. There is no endoscope inserted into the colon, hence the name "virtual.” The procedure may be highly effective at finding colon polyps or cancers, while sparing people the actual procedure of colonoscopy. However, the preparation for the two techniques is the same, requiring a thorough bowel cleaning for good results. And the patient will still need a traditional colonoscopy if polyps are found.
Additional resources
Colonoscopy-What to Expect [3]
Sigmoidoscopy-What to Expect [4]
Upper Endoscopy-What to Expect [5]
Last Updated: February 03, 2011