Endoscopy
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2008-07-16T00:21:26Z
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robot Adding: [[hu:Endoszkópia]]
[[Image:Am ulcer.gif|thumb|200px|Endoscopic images of a duodenal ulcer]]
[[Image:Flexibles Endoskop.jpg|right|thumb|200px|A flexible endoscope.]]
'''Endoscopy''' means ''looking inside'' and typically refers to looking inside the body for medical reasons using an instrument called an '''endoscope'''. Endoscopy can also refer to using a [[borescope]] in technical situations where direct line-of-sight observation is not feasible.
== Overview ==
Endoscopy is a [[minimally invasive]] [[diagnostic]] [[medical procedure]] that is used to assess the interior surfaces of an organ by inserting a tube into the body. The instrument may have a rigid or flexible tube and not only provide an image for [[visual]] inspection and [[photograph]]y, but also enable taking biopsies and retrieval of foreign objects. Endoscopy is the vehicle for [[minimally invasive surgery]].
Many endoscopic procedures are considered to be relatively painless and, at worst, associated with mild discomfort; for example, in [[esophagogastroduodenoscopy]], most patients tolerate the procedure with only topical anaesthesia of the [[oropharynx]] using [[Lidocaine|lignocaine]] spray. <ref>{{cite web |author=National Digestive Diseases Information Clearinghouse |title=Upper Endoscopy |url=http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/index.htm |date=November 2004 |publisher=National Institutes of Health |accessdate=2007-10-07}}</ref> Complications are not common (only 5% of all operations) {{fact|date = March 2007}} but can include perforation of the organ under inspection with the endoscope or biopsy instrument. If that occurs open surgery may be required to repair the injury.
==Components==
An endoscope can consist of
*a rigid or flexible [[tube]]
*a light delivery system to illuminate the [[organ (anatomy)|organ]] or object under inspection. The light source is normally outside the body and the light is typically directed via an [[optical fiber]] system
*a [[lens (optics)|lens]] system transmitting the [[image]] to the viewer from the [[fiberscope]]
*an additional channel to allow entry of [[medical instrument]]s or manipulators
==Uses==
Endoscopy can involve
*The [[gastrointestinal tract]] (GI tract):
**[[esophagus]], [[stomach]] and [[duodenum]] ([[esophagogastroduodenoscopy]])
**[[small intestine]]
**[[colon (anatomy)|colon]] ([[colonoscopy]],[[proctosigmoidoscopy]])
**[[Bile duct]]
***[[endoscopic retrograde cholangiopancreatography]] (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy
*The [[respiratory tract]]
**The [[nose]] ([[rhinoscopy]])
**The lower [[respiratory tract]] ([[bronchoscopy]])
*The [[urinary tract]] ([[cystoscopy]])
*The female [[reproductive system]]
**The [[cervix]] ([[colposcopy]])
**The [[uterus]] ([[hysteroscopy]])
**The [[Fallopian tube]]s ([[Falloscopy]])
*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]])
*During [[pregnancy]]
**The [[amnion]] ([[amnioscopy]])
**The [[fetus]] ([[fetoscopy]])
*Plastic Surgery
*Panendoscopy (or triple endoscopy)
**Combines [[laryngoscopy]], [[Esophagogastroduodenoscopy|esophagoscopy]], and [[bronchoscopy]]
*Non-medical uses for endoscopy
**The planning and architectural community have found the endoscope useful for pre-visualization of scale models of proposed buildings and cities ([[architectural endoscopy]])
**Internal inspection of complex technical systems ([[borescope]])
**Endoscopes are also a tool helpful in the examination of [[improvised explosive devices]] by [[bomb disposal]] personnel.
**The FBI uses endoscopes for conducting surveillance via tight spaces.
==History==
The first endoscope, of a kind, was developed in 1806 by [[Philip Bozzini]] with his introduction of a "Lichtleiter" (light conductor) "for the examinations of the canals and cavities of the human body". However, the [[Vienna Medical Society]] disapproved of such curiosity. An endoscope was first introduced into a human in 1822 by William Beaumont, an army surgeon at [[Mackinac Island, Michigan]]{{fact|date = March 2007}}. The use of electric light was a major step in the improvement of endoscopy. The first such lights were external. Later, smaller bulbs became available making internal light possible, for instance in a [[hysteroscopy|hysteroscope]] by [[Charles David (physician)|Charles David]] in 1908{{fact|date = March 2007}}. [[Hans Christian Jacobaeus]] has been given credit for early endoscopic explorations of the abdomen and the thorax with [[laparoscopy]] (1912) and [[thoracoscopy]] (1910){{fact|date = March 2007}}. Laparoscopy was used in the diagnosis of [[liver]] and [[gallbladder]] disease by [[Heinz Kalk]] in the 1930s{{fact|date = March 2007}}. Hope reported in 1937 on the use of laparoscopy to diagnose [[ectopic pregnancy]]{{fact|date = March 2007}}. In 1944, Raoul Palmer placed his patients in the [[Trendelenburg position]] after gaseous distention of the abdomen and thus was able to reliably perform [[gynecology|gynecologic]] laparoscopy{{fact|date = March 2007}}.
==Risks==
*Infection
*Punctured organs
*Allergic reactions due to [[Contrast agents]] or dyes (such as those used in a [[CT scan]])
*Over-sedation
==After the endoscopy==
After the procedure the patient will be observed and monitored by a qualified individual in the endoscopy or a recovery area until a significant portion of the medication has worn off. Occasionally a patient is left with a mild sore throat, which promptly responds to saline gargles, or 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 his/her usual diet (probably within a few hours) and will be allowed to be taken home. Because of the use of sedation, most facilities mandate that the patient is taken home by another person and not to drive on his/her own or handle machinery for the remainder of the day.
==Recent developments==
With the application of robotic systems, telesurgery was introduced as the surgeon could operate from a site physically removed from the patient. The first transatlantic surgery has been called the [[Lindbergh Operation]].
== See also ==
* [[Angiography]]
* [[Fiberscope]]
* [[Robotic surgery]]
==References==
* {{cite journal |author=Siegler AM, Kemmann E |title=Hysteroscopy |journal=Obstet Gynecol Surv |volume=30 |issue=9 |pages=567–88 |year=1975 |pmid=1099495|doi=10.1097/00006254-197509000-00001}}
* Armin Gärtner; medical technics and information technologie, Band II. Medizintechnik und Informationstechnologie, Band II. ISBN 3-8249-0941-3.
* Obituary: Professor Harold Hopkins, FRS, ''The Times'', 3 Nov 1994.
* {{cite journal |author=Sivak MV |title=Polypectomy: looking back |journal=Gastrointest. Endosc. |volume=60 |issue=6 |pages=977–82 |year=2004 |pmid=15605015 |doi= 10.1016/S0016-5107(04)02380-6|url=http://linkinghub.elsevier.com/retrieve/pii/S0016510704023806}}
==Footnotes==
{{reflist|2}}
Bittner JG, et al. Resident training in flexible gastrointestinal endoscopy: a review of current issues and options. J Surg Educ. 2007 Nov-Dec;64(6):399-409. PMID: 18063277
== External links ==
* [http://www.endoscopy.com Resources for people who use endoscopes.]
* [http://www.hindawi.com/journals/dte/ Diagnostic and Therapeutic Endoscopy - Open-Access Journal]
* [http://daveproject.org/ DAVE Project], Digital Atlas of Video Education - Gastroenterology
* [http://www.grs.nhs.uk/ Global Rating Scale], GRS - Quality Assurance for Endoscopy
* [http://www.endoscopecomponent.com Endoscope Repair Parts]
* [http://www.omed.org/downloads/pdf/publications/how_i_doit/2007/omed_hid_removing_large_or_sessile_colonic_polyps.pdf "How I Do It" — Removing large or sessile colonic polyps]. Dr. Brian Saunders MD FRCP; St. Mark’s Academic Institute; Harrow, Middlesex, UK. Retrieved April 9, 2008.
[[Category:Medical equipment]]
[[Category:Medical tests]]
[[Category:Gastroenterology]]
[[Category:endoscopy| ]]
[[Category:Optical devices]]
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