Endoscopy: Types, preparation, procedure, and risks

Endoscopy is the insertion of a long, thin tube directly into the body to observe an internal organ or tissue in detail. It can also be used to carry out other tasks including imaging and minor surgery.

Endoscopes are minimally invasive and can be inserted into the openings of the body such as the mouth or anus.

Alternatively, they can be inserted into small incisions, for instance, in the knee or abdomen. Surgery completed through a small incision and assisted with special instruments, such as the endoscope, is called keyhole surgery.

Because modern endoscopy has relatively few risks, delivers detailed images, and is quick to carry out, it has proven incredibly useful in many areas of medicine. Today, tens of millions of endoscopies are carried out each year.

In this article, we will explain some of the types of endoscopy, why and how they are performed, the general procedure, and any potential risks.

Fast facts on endoscopy

Here are some key points about endoscopy. More detail and supporting information is in the main article.

Endoscopies are quick and relatively safe procedures.

The first endoscope was designed in 1806.

The main reasons for endoscopy are investigation, confirmation, and treatment.

Endoscopy can be used to remove tumors or polyps from the digestive tract.

Types

[Surgeon preparing for an endoscopy]
Endoscopy can be useful in a wide array of medical situations.

Endoscopy is useful for investigating many systems within the human body; these areas include:

Gastrointestinal tract: esophagus, stomach, and duodenum (esophagogastroduodenoscopy), small intestine (enteroscopy), large intestine/colon (colonoscopy, sigmoidoscopy), bile duct, rectum (rectoscopy), and anus (anoscopy).

Respiratory tract: Nose (rhinoscopy), lower respiratory tract (bronchoscopy).

Ear: Otoscopy

Urinary tract: Cystoscopy

Female reproductive tract (gynoscopy): Cervix (colposcopy), uterus (hysteroscopy), fallopian tubes (falloposcopy).

Through a small incision: Abdominal or pelvic cavity (laparoscopy), interior of a joint (arthroscopy), organs of the chest (thoracoscopy and mediastinoscopy).

What is a capsule endoscopy?

Capsule endoscopy was developed in the mid-1990s and involves a wireless camera. The camera is small enough to fit into a capsule (roughly the size of a vitamin tablet) and can, therefore, be swallowed.

As the capsule travels through the digestive tract, it takes thousands of pictures, which are transmitted to a device attached to a wearable belt.

Capsule endoscopy is used to image the small intestine, a region that is difficult to image using standard endoscopy. It is also very useful for examining the small intestinal mucosa and diagnosing Crohn’s disease. The capsule usually passes through the digestive system within 24-48 hours.

This is a relatively new technique and was given FDA approval for use in the United States in 2001. To date, more than 500,000 capsule endoscopy procedures have been carried out, and nearly 1,000 articles have been published covering its clinical use.

Female patient sitting across desk from female doctor, discussing problem.
Advice will be provided by a doctor on how to prepare for an endoscopy, as different procedures will have different requirements.

The procedure does not require an overnight stay in the hospital and usually only takes around 1 hour to complete. The doctor will provide instructions about the preparation for the procedure.

For many types of endoscopy, the individual needs to fast for around 12 hours, though this varies based on the type.

For procedures investigating the gut, laxatives may be taken the night before to clear the system.

A doctor will carry out an examination before the endoscopy. It is important to mention all current medications (including supplements) and any previous procedures.

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