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Endoscopy
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{{Short description|Procedure used in medicine to look inside the body}} {{For|the notion in mathematics|Endoscopic group}} {{more citations needed|date=January 2016}} {{Infobox medical intervention |Name = Endoscopy |Image = Endoscopy_start.jpg |Caption = An example of an endoscopic procedure |ICD10 = |ICD9 = |MeshID = D004724 |MedlinePlus = 003338 |OPS301 = {{OPS301|1-40...1-49}}, {{OPS301|1-61...1-69}} |OtherCodes = | }} An '''endoscopy''' is a procedure used in [[medicine]] to look inside the body.<ref>{{cite encyclopedia |title=Endoscopy |encyclopedia=British Medical Association Complete Family Health Encyclopedia |year=1990 |publisher=Dorling Kindersley Limited |isbn=978-0-751-30161-8 }}</ref> The endoscopy procedure uses an [[endoscope]] to examine the interior of a hollow organ or cavity of the body. Unlike many other [[medical imaging]] techniques, endoscopes are inserted directly into the organ. There are many types of endoscopies. Depending on the site in the body and type of procedure, an endoscopy may be performed by a doctor or a [[surgeon]]. During the procedure, a patient may be fully conscious or [[anaesthesia|anaesthetised]]. Most often, the term ''endoscopy'' is used to refer to an examination of the upper part of the [[human gastrointestinal tract|gastrointestinal tract]], known as an [[esophagogastroduodenoscopy]].<ref>{{cite web |title=Endoscopy |url=http://www.cancerresearchuk.org/about-cancer/cancers-in-general/tests/endoscopy |publisher=Cancer Research UK |access-date=5 November 2015 |archive-date=1 February 2017 |archive-url=https://web.archive.org/web/20170201224116/http://www.cancerresearchuk.org/about-cancer/cancers-in-general/tests/endoscopy |url-status=dead }}</ref> Similar instruments are called [[borescopes]] for nonmedical use. ==History== [[Adolf Kussmaul]] was fascinated by [[sword swallowers]] who would insert a sword down their throat without gagging. This drew inspiration to insert a hollow tube for observation; the next problem to solve was how to shine light through the tube, as they were still relying on candles and oil lamps as light sources.<ref>{{Cite web|url=https://www.entandaudiologynews.com/features/ent-features/post/the-pioneers-of-endoscopy-and-the-sword-swallowers|title=The pioneers of endoscopy and the sword swallowers|access-date=2022-01-26|archive-date=2022-01-27|archive-url=https://web.archive.org/web/20220127172040/https://www.entandaudiologynews.com/features/ent-features/post/the-pioneers-of-endoscopy-and-the-sword-swallowers|url-status=live}}</ref> The term ''endoscope'' was first used on February 7, 1855, by engineer-optician Charles Chevalier, about the ''uréthroscope'' of [[Antonin Jean Desormeaux|Désormeaux]], who himself began using the former term a month later.<ref name="auto">{{Cite journal|last=Janssen|first=Diederik F|date=2021-05-17|title=Who named and built the Désormeaux endoscope? The case of unacknowledged opticians Charles and Arthur Chevalier|url=http://journals.sagepub.com/doi/10.1177/09677720211018975|journal=Journal of Medical Biography|volume=29|issue=3|language=en|pages=176–179|doi=10.1177/09677720211018975|pmid=33998906|s2cid=234747817|issn=0967-7720|access-date=2021-05-17|archive-date=2023-02-04|archive-url=https://web.archive.org/web/20230204054342/https://journals.sagepub.com/doi/10.1177/09677720211018975|url-status=live|url-access=subscription}}</ref> The self-illuminated endoscope was developed at [[Glasgow Royal Infirmary]] in [[Scotland]] (one of the first hospitals to have mains electricity) in 1894/5 by [[John Macintyre]] as part of his specialization in the investigation of the larynx.<ref>{{cite web | url = http://sshm.ac.uk/wp-content/uploads/2013/10/PROCEEDINGS-SESSION-1994-1995-and-1995-1996.pdf | title = The Scottish Society of the History of Medicine | access-date = 2017-07-11 | archive-date = 2016-12-20 | archive-url = https://web.archive.org/web/20161220090937/http://sshm.ac.uk/wp-content/uploads/2013/10/PROCEEDINGS-SESSION-1994-1995-and-1995-1996.pdf | url-status = live }}</ref>{{Failed verification|date=April 2019|reason=This source doesn't mention the years; it says: "Even before using X-rays he had pioneered the development of self-illuminated endoscopes"}} ==Medical uses== [[File:PENTAX Colonoscope002.jpg|thumb|Operation part of the endoscope]] [[File:Insertion tip of endoscope.jpg|thumb|Insertion tip of an endoscope]] Endoscopy may be used to investigate symptoms in the [[digestive system]] including [[nausea]], [[vomiting]], [[abdominal pain]], [[difficulty swallowing]], and [[gastrointestinal bleeding]].<ref name="mayoendo">{{cite web |url=http://www.mayoclinic.com/health/endoscopy/MY00138/METHOD=print |title=Upper endoscopy |author=Staff |work=Mayo Clinic |year=2012 |access-date=24 September 2012 |archive-date=25 May 2013 |archive-url=https://web.archive.org/web/20130525230502/http://www.mayoclinic.com/health/endoscopy/MY00138/METHOD=print |url-status=live }}</ref> It is also used in diagnosis, most commonly by performing a biopsy to check for conditions such as [[anemia]], bleeding, [[inflammation]], and [[Digestive system neoplasm|cancers of the digestive system]].<ref name="mayoendo"/> The procedure may also be used for treatment such as [[cauterization]] of a bleeding vessel, widening a narrow esophagus, clipping off a polyp, or removing a foreign object.<ref name="mayoendo"/> [[Specialty (medicine)|Specialty]] [[professional organizations]] that specialize in digestive problems advise that many patients with [[Barrett's esophagus]] receive endoscopies too frequently.<ref name="AGAfive">{{Citation|author1=American Gastroenterological Association |author1-link=American Gastroenterological Association |title=Five Things Physicians and Patients Should Question |publisher=[[American Gastroenterological Association]] |work=Choosing Wisely: an initiative of the [[ABIM Foundation]] |url=http://choosingwisely.org/wp-content/uploads/2012/04/5things_12_factsheet_AGA.pdf |access-date=August 17, 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120809143636/http://choosingwisely.org/wp-content/uploads/2012/04/5things_12_factsheet_AGA.pdf |archive-date=August 9, 2012 }}</ref> Such societies recommend that patients with Barrett's esophagus and no cancer symptoms after two biopsies receive biopsies as indicated and no more often than the recommended rate.<ref name=pmid21376940>{{cite journal | vauthors = Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ | title = American Gastroenterological Association medical position statement on the management of Barrett's esophagus | journal = Gastroenterology | volume = 140 | issue = 3 | pages = 1084–91 | date = March 2011 | pmid = 21376940 | doi = 10.1053/j.gastro.2011.01.030 | doi-access = free }}</ref><ref name=pmid18341497>{{cite journal | vauthors = Wang KK, Sampliner RE | title = Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus | journal = The American Journal of Gastroenterology | volume = 103 | issue = 3 | pages = 788–97 | date = March 2008 | doi = 10.1111/j.1572-0241.2008.01835.x | pmid = 18341497 | s2cid = 8443847 | doi-access = free }}</ref> ===Applications=== [[File:Anoscope, proctoscope and rectoscope.svg|thumb|250px|An [[anoscope]], a [[proctoscope]], and a [[rectoscope]] with approximate lengths]] [[File:US Navy 081117-N-7526R-568 Cmdr. Thomas Nelson and Lt. Robert Roadfuss discuss proper procedures while performing a laparoscopic cholecystectomy surgery.jpg|thumb|250px|Endoscopy surgery]] [[File:Esophageal Bougie Dilator.jpg|thumb|Esophageal Bougie Dilator]] Health care providers can use endoscopy to review any of the following body parts: * The [[Human gastrointestinal tract|gastrointestinal tract]] (GI tract): ** [[oesophagus]], [[stomach]] and [[duodenum]] ([[esophagogastroduodenoscopy]]) ** [[small intestine]] ([[enteroscopy]]) ** [[large intestine]]/[[colon (anatomy)|colon]] ([[colonoscopy]], [[sigmoidoscopy]]) ** Magnification endoscopy ** [[bile duct]] *** [[endoscopic retrograde cholangiopancreatography]] (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy ** [[rectum]] (rectoscopy) and [[Human anus|anus]] ([[anoscopy]]), both also referred to as ([[proctoscopy]]) * The [[respiratory tract]] ** The [[human nose|nose]] ([[rhinoscopy]]) ** The upper [[respiratory tract]] ([[laryngoscopy]]) ** The lower [[respiratory tract]] ([[bronchoscopy]]) * The [[ear]] ([[otoscope]]) * The [[Urinary bladder]] ([[cystoscopy]]) ** The [[Ureter]] ([[ureteroscopy]]) * The [[female reproductive system]] (gynoscopy) ** The [[cervix]] ([[colposcopy]]) ** The [[uterus]] ([[hysteroscopy]]) ** The [[fallopian tube]]s ([[falloposcopy]]) * Normally closed body cavities (through a small incision): ** The abdominal or pelvic cavity ([[laparoscopy]]) ** The interior of a joint ([[arthroscopy]]) ** Organs of the chest ([[thoracoscopy]] and [[mediastinoscopy]]) Endoscopy is used for many procedures: * During [[pregnancy]] ** The [[amnion]] (amnioscopy) ** The [[fetus]] ([[fetoscopy]]) * [[Plastic surgery]] * Panendoscopy (or triple endoscopy) ** Combines [[laryngoscopy]], [[Esophagogastroduodenoscopy|esophagoscopy]], and [[bronchoscopy]] * [[Orthopedic surgery]] ** [[Hand surgery]], such as [[endoscopic carpal tunnel release]] ** [[Knee surgery]], such as [[anterior cruciate ligament reconstruction]] ** [[Epidural space]] (epiduroscopy) ** [[Bursa (anatomy)|Bursae]] ([[bursectomy]]) * [[Endodontic]] surgery ** [[Maxillary sinus]] surgery ** [[Apicoectomy]] * [[Endoscopic endonasal surgery]] * [[Endoscopic spinal surgery]] * Endoscopic [[nerve decompression]] for [[Peripheral nervous system|peripheral nerves]] An endoscopy is a simple procedure that allows a doctor to look inside human bodies using an instrument called an endoscope. A cutting tool can be attached to the end of the endoscope, and the apparatus can then be used to perform minor procedures such as tissue biopsies, banding of oesophageal varices, or removal of polyps. ==Application in other fields== * For non-medical use, such as internal inspection of complex technical systems, [[borescopes]] are used. These are similar to endoscopes. * The planning and architectural community use [[architectural endoscopy]] for pre-visualization of scale models of proposed buildings and cities * Endoscopes are also a tool helpful in the examination of [[improvised explosive devices]] by [[bomb disposal]] personnel. * Law enforcement uses endoscopes for conducting surveillance via tight spaces. ==Risks== The main risks are infection, over-sedation, perforation, or a tear of the stomach or esophagus lining and bleeding.<ref name="NHS">{{cite web |url=http://www.nhs.uk/conditions/Endoscopy/Pages/Introduction.aspx |title=Endoscopy |author=<!--Not stated--> |website=NHS Choices |publisher=NHS Gov.UK |access-date=April 20, 2017 |archive-date=May 2, 2017 |archive-url=https://web.archive.org/web/20170502024143/http://www.nhs.uk/conditions/endoscopy/pages/introduction.aspx |url-status=live }}</ref> Although perforation generally requires surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of a biopsy or polyp removal. Such typically minor bleeding may simply stop on its own or be controlled by cauterisation. Surgery became necessary. Perforation and bleeding are rare during gastroscopy. Other minor risks include drug reactions and complications related to other diseases the patient may have. Consequently, patients should inform their doctor of all allergic tendencies and medical problems. Occasionally, the site of the [[sedative]] injection may become inflamed and tender for a short time. This is usually not serious, and warm compresses for a few days are usually helpful. While any of these complications may occur, each of them occurs quite infrequently. A doctor can further discuss risks with the patient about the particular need for gastroscopy. ==After the endoscopy== After the procedure, the patient will be observed and monitored by a qualified individual in the endoscopy room or a recovery area until a significant portion of the medication has worn off. Occasionally, the patient is left with a mild sore throat, which may respond to saline gargles or chamomile tea. It may last for weeks or not happen at all. The patient may have 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 their usual diet (probably within a few hours) and will be allowed to be taken home. Where sedation has been used, most facilities mandate that the patient be taken home by another person and that they not drive or handle machinery for the remainder of the day. Patients who have had an endoscopy without sedation can leave unassisted. == References == {{Reflist}} == External links == {{Commons category|Endoscopy}} {{Wikt|endoscopy}} * [https://web.archive.org/web/20120418055511/http://www.endoatlas.com/atlas_1.html The Atlas of Gastrointestinal Endoscopy] endoatlas.com * [https://www.gastrointestinalatlas.com/english/english.html El Salvador Atlas of Gastrointestinal Endoscopy] * [http://www.gastrolab.net/welcome.htm Gastrolab: Site in English, Swedish and Finnish with gastrointestinal endoscopy photolibrary] {{Webarchive|url=https://web.archive.org/web/20200710124824/http://www.gastrolab.net/welcome.htm |date=2020-07-10 }} * [https://web.archive.org/web/20110513090434/http://www.massdevice.com/blogs/massdevice/preventing-cross-contamination-flexible-endoscopes Preventing cross-contamination from flexible endoscopes] massdevice.com * [http://www.advancedimagingpro.com/print/Advanced-Imaging-Magazine/Advances-in-Endoscopy/1$5670 Advances in Endoscopy] {{Webarchive|url=https://web.archive.org/web/20180513011613/http://www.advancedimagingpro.com/print/Advanced-Imaging-Magazine/Advances-in-Endoscopy/1$5670 |date=2018-05-13 }} advancedimagingpro.com {{Endoscopy|state=expanded}} {{Surgery}} {{Authority control}} [[Category:Endoscopy| ]] [[Category:Diagnostic gastroenterology]]
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