Endoscopy is a medical procedure that allows a doctor to observe the inside of the body without performing major surgery. An endoscope (fibrescope) is a long flexible tube with a lens at one end and a video camera at the other.
The end with the lens is inserted into the patient. Light passes down the tube (via bundles of optical fibres) to illuminate the relevant area, and the video camera magnifies the area and projects it onto a television screen so the doctor can see what is there. Usually, an endoscope is inserted through one of the body’s natural openings, such as the mouth, urethra, or anus.
Specially designed endoscopes are used to perform simple surgical procedures, such as:
- Locating, sampling or removing tumours from the lungs and digestive tract.
- Locating and removing foreign objects from the lungs and digestive tract.
- Taking small samples of tissue for diagnostic purposes (biopsy).
- Removing stones from the bile duct.
- Placing tubes (stents) through blockages in the bile duct, oesophagus, duodenum, or colon.
A range of endoscopes
Endoscopes have been developed for many parts of the body. Each has its own name, depending on the part of the body it is intended to investigate, such as:
- Bronchoscope – inserted down the trachea (windpipe) to examine the lung.
- Colonoscope – inserted through the anus to examine the colon (bowel).
- Gastroscope – inserted down the oesophagus to examine the stomach.
- Duodenoscope – inserted through the stomach into the duodenum to inspect and perform procedures on the bile duct and /or pancreatic duct, called ERCP (Endoscopic Retrograde Cholangio-Pancreatogram).
- Hysteroscope – inserted through the cervix to examine the uterus.
- Cystoscope and ureteroscope - inserted via the urethra to inspect the urinary bladder and ureters.
Medical issues to consider
Depending on the condition under investigation, some endoscopies can be carried out in the doctor’s surgery. Others need a trip to hospital or day surgery facility, and may require a general anaesthetic.
Endoscopies are generally painless, although they may still cause some discomfort. Compared with the stress experienced by the body in a full surgical procedure, an endoscopy is simple, low risk, and cost effective. Other advantages include:
- No scar – as a natural body opening is used.
- Quick recovery time.
- Less time in hospital. Often, no time in hospital is required as the procedure is performed in the doctor’s rooms.
The exact procedure used depends on the type of endoscopy and choice of anaesthesia. You may have sedation or a general anaesthetic.The endoscope is inserted through a natural opening. The doctor may simply make a diagnosis. They may also take a sample of tissue (biopsy) for later analysis in a laboratory.
Alternatively, your doctor could perform minor surgery at the same time. For example, they may place a stent across an obstructing tumour or remove a stone from a bile duct. Once the endoscopy is complete, the endoscope is removed.
Services offered at Cumberland Medical Center
EGD is an endoscopic examination of the esophagus, stomach, and duodenum (the first part of the small intestine). A gastroscope, a lighted flexible device with a camera attached to the end, is inserted into the throat via the mouth and guided downward through the upper gastrointestinal tract. This allows the Endoscopy physician to directly view the inner lining of the esophagus, stomach, and duodenum. The physician also looks for hiatal hernias, polyps, strictures, ulcers, inflammation, diverticulosis, etc. The physician may also perform a biopsy on suspicious tissue, such as suspected Barrett’s esophagus.
Colonoscopy is an endoscopic examination of large intestine (rectum and colon). A colonoscope, a lighted flexible device with a camera attached to the end, is used. A colonoscopy helps to find ulcers, colon polyps, tumors, and areas of inflammation or bleeding. Tissue samples (biopsy) can be collected and abnormal growths, such as polyps, can be removed. Colonoscopy is also used as a screening test to check for cancer or precancerous growths in the colon or rectum.
The PillCam SB is used to directly visualize the small bowel to detect, diagnose, and monitor abnormalities by allowing the physician to see the entire small bowel. The PillCam SB is the size of a vitamin capsule and is simply swallowed with sips of water. The physician looks for and monitors lesions, tumors, ulcers, and bleeding within the small bowel.
Bravo pH Monitoring
Bravo pH Monitoring is a test used to confirm if a patient’s symptoms are caused by GERD (Gastroesophageal Reflux Disease). Bravo pH monitoring identifies the presence of acid back flowing into the esophagus. Bravo pH monitoring is patient-friendly, capsule-based, and catheter-free. During an EGD, a miniature capsule is attached to the esophagus. pH data from the esophagus is wirelessly transmitted to a small recorder worn on a shoulder strap or a waistband. Information is collected over 48 hours, which allows the physician to evaluated GERD symptoms by determining the frequency and duration of acid flowing back up into the esophagus. Regular activities, including showering and sleep, and a normal diet are maintained during the test provide a more accurate picture of acid exposure compared to data collected using a catheter.
Esophageal Motility (Manometry)
Esophageal motility study or manometry records the pressures and coordination of the muscles of the esophagus. It is used to evaluate the action of the muscle waves (peristalsis) in the main portion of the esophagus as well as the valve at the lower end of the esophagus. If the muscular contractions are weak or uncoordinated interfering with the movement of food and fluids down the esophagus, the condition is known as a motility disorder. Motility disorders cause dysphagia or difficulty in swallowing, regurgitation of food, and even a spasm-like pain in the chest. The motility test is performed on an outpatient basis. A small tube is passed down the patient’s nose into the stomach. With the tube in place, the patient is instructed to drink sips of water. The nurse performing the test measures the strength and coordination of the esophageal muscle contractions. Motility disorders, such as achalasia and nutcrackers, have very characteristic anomalies of esophageal muscle function that is evident during the test.
HALO Procedure - (Click Here)
HALO Procedure - (Click Here)
HALO ablation technology is a technique that is used to treat Barrett’s esophagus. The HALO technology is a very specific type of ablation, in which the heat energy is delivered in a precise and highly-controlled manner. The affected tissue is heated until it is no longer viable or alive. The diseased tissue is then replaced by normal tissue. Barrett’s tissue can be completely eliminated with the HALO ablation technology in 98.4% of patients. The ablation procedure is performed in conjunction with an Esophagoscopy (endoscopic examination of the esophagus) on an outpatient basis.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
An ERCP is a procedure that uses a flexible, lighted endoscope along with X-ray pictures to examine the ducts or tubes that drain the liver, gallbladder, and pancreas. The endoscope is inserted through the mouth and slowly advance down the throat, esophagus, stomach, and duodenum until the physician reaches the point where the ducts from the gallbladder (bile ducts) and pancreas (pancreatic ducts) meet and drain into the duodenum (first section of the small bowel). ERCP can treat certain problems that are discovered during the procedure such as biopsy of abnormal tissue, remove a gallstone present in the common bile duct, insert a stent in a narrow duct. ERCP is done for the following reasons:
• Evaluate persistent abdominal pain or jaundice
• Find gallstones or diseases of the liver, bile ducts, or pancreas
• Remove gallstones that blocking the common bile duct
• Open a narrow bile duct or insert a drain (stent)
Transoral Incisionless Fundoplication (TIF) Procedure
Transoral Incisionless Fundoplication or TIF procedure reconstructs a durable gastroesophageal valve reestablishing a barrier to the reflux of stomach acid back into the esophagus thus eliminating GERD. TIF is completely incisionless and is considered a NOS (Natural Orifice Surgery) procedure. An Esophyx® repair device is used to reconstruct the valve. The device is introduced into the body through the mouth and advanced into the esophagus under visualization by a video camera. The device is then used to form and fasten several folds of tissue to recreate the antireflux valve. In the weeks following the procedure, the natural healing process fuses and cements the tissue folds together creating the barrier. The procedure is performed under a general anesthesia. Most patients go home the next day and resume normal activities within a few days.
Bronchoscopy is a procedure that allows your physician to look your airway, including your throat, larynx, trachea, and lungs. A flexible bronchoscope is used by the physician. Bronchoscopy is performed to diagnose problems of the airway and lungs.