Introduction to Endoscopy
Endoscopy is the investigation of body cavities and organs by means the insertion of rigid or flexible tubes of varying diameter. At the leading end of these tubes there is found the usual arrangement of a light source, a means of conveying images to the operator and an access channel.
Upper and Lower Gastrointestinal Endoscopy
The general surgeon will often perform endoscopic examination of the upper and lower gastrointestinal tract. The procedures are vital for accurate diagnosis of many conditions of the gut and with improved technological advances and with specialised skills surgeons are able to carry out an ever increasing array of therapeutic interventions that in the past would have required more major surgery.
Investigations are carried out both with and without sedation and often without the need for full bowel preparation.
Procedures
OGD (Oesophago-Gastro-Duodenoscopy)
An endoscope is inserted through the mouth to visualise the oesophagus (gullet), stomach and duodenum
An endoscope is inserted through the anal canal and rectum to visualise these structures as well as the left side of the colon.
An endoscope is inserted through the anal canal and rectum to visualise the whole of the colon.
ERCP (Endoscopic Retrograde Cholangio-Pancreatography)
An endoscope is inserted through the mouth to visualise the duodenum and access the biliary tree (pancreas, bile ducts, gall bladder and liver)
TEMS (Trans Anal Endoscopic Microsurgery)
Under a general anaesthetic a rigid operating endoscope is inserted through the anal canal to visualise and remove polyps and tumours of the anal canal and rectum.
Purposes of Endoscopy:-
Diagnostic
- Visualisation of the lining of the gut
- Biopsy of the lining of the gut
- Combined use of x-ray and ultrasound techniques
Therapeutic
- Removal of polyps or tumours by snare, EMR (endoscopic mucosal resection) or microsurgery
- Insertion of stents (expanding wire cages) to treat obstruction
- Control of bleeding by injection, clipping, banding and the application of heat