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Dictionary:

Endoscopy


n.

(Med.) The art or process of examination or treatment by means of an endoscope.

 
 
World of the Body: endoscopy

Endoscopy is the process whereby an optical instrument is introduced into one or other of the body tubes or cavities so that the organs of the body may be directly inspected. The instruments of endoscopy are most usually inserted through existing orifices, such as the mouth and rectum, but in certain cases an incision may be made so that otherwise inaccessible body cavities may be examined. The word is derived from the Greek endon ‘within’ and scopeo ‘examine’.

The earliest endoscopic examinations, introduced in the mid nineteenth century, were of the throat and larynx. Using mirrors placed carefully at the back of the throat it became possible to examine the vocal cords directly. The key technological advance was the ability to develop a light source which could be directed at the organ or tissues to be examined. Laryngoscopy became the technique which encouraged the development of ear, nose, and throat surgery.

Gradually, other endoscopic techniques were introduced. Examination of the rectum and colon were made possible by the development of colonoscopes, but in the early days the rigidity of the instruments available limited examination to the lower colon and rectum. Similarly, at the upper end of the alimentary tract, rigid instruments were used for the examination of the oesophagus (oesophagoscopy) and for the stomach, the earliest gastroscopes were introduced in Germany during the 1930s. During the next two decades, bronchoscopy (introducing an instrument into the bronchial tree via the locally anaesthetized throat, larynx, and trachea) became a significant technique because of the increasing incidence of cancer of the lung, for which this was for some time the most important tool in diagnosis. At the same time, urologists were using comparable instruments to examine the bladder, a technique of great importance in the diagnosis of cancer or of prostatic disease. Since there was no direct access to the thoracic or abdominal cavities, instruments were inserted through incisions made in the chest wall or abdomen, enabling operators to examine the lungs directly and to carry our surgical procedures (thoracoscopy), or to examine the liver and other abdominal organs (peritoneoscopy: looking within the peritoneal cavity). Peritoneoscopy also became an important technique which enabled the gynaecologist to examine the pelvic organs of women. By the 1950s there were therefore a wide range of endoscopic techniques available which greatly improved the methods of diagnosis of a variety of illnesses. The rigidity of the instruments, however, limited their use for the doctor and were in many instances particularly unpleasant for the patient, the passage of a rigid or semi-rigid gastroscope requiring the skills of a sword-swallower. Nevertheless, a whole generation of gastroenterologists became proficient in the technique, which was widely used for the diagnosis of peptic ulcer or cancer of the stomach.

A revolution in endoscopic techniques, however, followed the discovery of fibre optic instruments, since their flexibility permitted a far wider application than hitherto. Such techniques were to be of particular value in gastroenterology. It was at a social meeting in London that a physician, Hugh Gainsborough, met the physicist Harold Hopkins. He was pretty well appalled at the use of the rigid instruments in use for gastroscopy at that time and wondered whether Hopkins, already the discoverer of the zoom lens, could make an instrument that was flexible and therefore much more tolerable for the patient. Hopkins, then working at Imperial College in London, recruited a young research student (N. S. Kapany), and together they were able to develop a flexible fibreoptic bundle of glass fibres through which it was possible to examine an object. The significance of their invention was at once apparent to a distinguished British gastroenterologist, Sir Francis Avery Jones, who encouraged a young South African research worker, Dr Basil Hirschowitz, to try to explore the technique for clinical studies. It was not, however, possible to obtain the help of British industrial firms in this venture, and Hirschowitz later went to work in the US. There, he successfully pioneered the use of a fibreoptic bundle which could be introduced with relative ease into the stomach and, for the first time, beyond that into the duodenum, enabling duodenal ulcers to be directly examined. His work was at once followed up by Japanese workers in association with companies such as Olympus. It was they who introduced the new range of gastrointestinal endoscopes that have enabled clinicians directly to examine virtually the entire alimentary tract, as well as making it possible to visualize, with associated radiological techniques, organs such as the pancreas, which had until then been examined only by a major operation involving the opening of the alimentary tract. In addition, skilled operators were able to remove gallstones from the bile ducts. Flexible colonoscopy in particular brought the entire colon within view, as well as making it feasible to remove lesions such as polyps, considered to be premalignant, through the endoscope.

The use of fibreoptic endoscopy has been extended to other organs since its introduction, initially for the alimentary tract, so that it is now possible, for example, to introduce such instruments into the joints or major blood vessels to carry out surgical procedures.

There is little doubt that, in the history of endoscopy, the invention of the fibreoptic bundle by Hopkins and Kapany was a technological achievement that has transformed the practice of medicine in the modern era. Endoscopic ‘key-hole’ surgery continues to advance.

— Christopher Booth

Bibliography

  • Hirschowitz, B. I. (1961). Endoscopic examination of the stomach and duodenal cap with a fiberscope. Lancet, i. 1074-8.
  • Hopkins, H. H. and Kapany, N. S. (1956). A flexible fibrescope using static scanning. Nature, 173, 39-41

See also alimentary system; surgery.

 
Dental Dictionary: endoscopy

n

The visualization of the interior of organs and cavities of thebody with an illuminated, flexible optical tube.

 
Britannica Concise Encyclopedia: endoscopy

Examination of the body's interior through an instrument inserted into a natural opening or an incision, usually as an outpatient procedure. Endoscopes include the upper gastrointestinal endoscope (for the esophagus, stomach, and duodenum), the colonoscope (for the colon), and the bronchoscope (for the bronchial tubes). With fibre optics, much more maneuverable instruments can reach formerly inaccessible sites, while causing much less discomfort. Attachments can take tissue samples, excise polyps and small tumours, and remove foreign objects.

For more information on endoscopy, visit Britannica.com.

 
Veterinary Dictionary: endoscopy

Visual examination of interior structures of the body with an endoscope.

 
Wikipedia: Endoscopy
Endoscopic images of a duodenal ulcer
Enlarge
Endoscopic images of a duodenal ulcer
A flexible endoscope.
Enlarge
A flexible endoscope.

Endoscopy means looking inside and typically refers to looking inside the human 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 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 photography, 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. Most patients tolerate the procedure with only topical anaesthesia of the oropharynx using lignocaine spray (Source: Esophagogastroduodenoscopy, Wikipedia). [citation needed] Complications are rare (only 5% of all operations)[citation needed] 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 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 system transmitting the image to the viewer from the fiberscope
  • an additional channel to allow entry of medical instruments or manipulators

Uses

Endoscopy can involve

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[citation needed]. 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 hysteroscope by Charles David in 1908[citation needed]. Hans Christian Jacobaeus has been given credit for early endoscopic explorations of the abdomen and the thorax with laparoscopy (1912) and thoracoscopy (1910)[citation needed]. Laparoscopy was used in the diagnosis of liver and gallbladder disease by Heinz Kalk in the 1930s[citation needed]. Hope reported in 1937 on the use of laparoscopy to diagnose ectopic pregnancy[citation needed]. In 1944, Raoul Palmer placed his patients in the Trendelenburg position after gaseous distention of the abdomen and thus was able to reliably perform gynecologic laparoscopy[citation needed].

The first gastrocamera was released in 1950 by Olympus Optical Co., Ltd. The device took pictures on monochromatic film using a small light bulb that was triggered manually. The device was of limited use, however, because it did not implement real-time optical capability. Olympus continued its development of endoscopes by incorporating fiber optics in the early 1960s, leading to the first useful endoscopes. In 1964, it released a gastrocamera guided by a fiberscope.[1] A few articles claim that Dr.Basil Hirschowitz of Univ.Of Michigan,Ann Arbor discussed the endoscope in early 50's.[2]

As endoscopic technology improved, so did the methods of gastrointestinal endoscopy. Owing primarily to the efforts of Dr. Hiromi Shinya in the late 1960s, GI endoscopy developed into what is more recognizable as today's colonoscopy. While many doctors experimented with techniques to take advantage of the new iterations of endoscopes, Dr. Shinya focused on techniques that would allow for successful operation of the endoscope by an individual, rejecting the common practice at the time of utilizing two people. Consequently, many of the fundamental methods and procedures of modern colonoscopy were developed by Dr. Shinya.

Dr. Shinya's other great contribution was to therapeutic endoscopy, in his invention of the electrosurgical polypectomy snare with the aid of Olympus employee Hiroshi Ichikawa. Shinya sketched his first plans for the device on January 8, 1969. He envisioned a loop of wire attached to the end of a colonoscope that would allow for easy removal of polyps during investigation by passing a current through the wire. By September of 1969, the first polypectomy using this device was performed. Polypectomy has since become the most common therapeutic procedure performed with an endoscope. (Sivak 2004)

By 1980, laparoscopy training was required by gynecologists to perform tubal ligation procedures and diagnostic evaluations of the pelvis. The first laparoscopic cholecystectomy was performed in 1984 and the first video-laparoscopic cholecystectomy in 1987[citation needed]. During the 1990s, laparoscopic surgery was extended to the appendix, spleen, colon, stomach, kidney, and liver[citation needed]. Wireless capsule endoscopy or Capsule Endoscopy is now approved in all the countries including Japan where government reimbusement will be available from Oct.2007.Capsule Endoscopy [3] increases detection of Small Bowel tumors where traditional Endoscopy is not very efficient.

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

References

  • Siegler AM, Kemmann E: Hysteroscopy. Obstet Gynecol Survey 30:567-88, 1975.
  • 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.
  • Sivak, Jr., Michael V. (2004-12). "Polypectomy: Looking Back". Gastrointestinal Endoscopy 60 (6): 977-982. ISSN 1097-6779. 

External links


This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

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Copyrights:

Dictionary. Webster 1913 Dictionary edited by Patrick J. Cassidy  Read more
World of the Body. The Oxford Companion to the Body. Copyright © 2001, 2003 by Oxford University Press. All rights reserved.  Read more
Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved.  Read more
Britannica Concise Encyclopedia. Britannica Concise Encyclopedia. © 2006 Encyclopædia Britannica, Inc. All rights reserved.  Read more
Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia. This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Endoscopy".  Read more

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