Endoscopy

definition

The word "endoscopy" comes from the Greek and is translated from the two words "inside" (endon) and "observe" (skopein).

As the word suggests, endoscopy is a medical procedure in which a special device - the endoscope - can be used to look inside body cavities and hollow organs.

This procedure, also known as mirroring, enables the doctor to examine the body cavities or hollow organs examined, to identify any existing diseases there and possibly even to treat them on site during the endoscopy.

The device (endoscope) owns besides one optical system (camera) and one Cold light source also flexible and rigid toolsto be able to carry out a treatment.

General a distinction is made on the one hand between one rigid, immovable endoscope (e.g. arthroscope for joint reflections) and a flexible, movable endoscope (e.g. endoscope for gastrointestinal mirroring) and on the other hand between a purely diagnostic endoscopy (for diagnosis and tissue sampling) and the therapeutic endoscopy (for interventions, also called minimally invasive surgery).

Indications

The Indications for an endoscopy can be viewed quite generally in divided into four large groups become:

For one, endoscopy is mainly used too diagnostic purposes used. The attending physician can do this during the examination respective organ or the respective body cavity assess and - if necessary - also tissue samples (Biopsies) so that an exact diagnosis can then be made.
Classically this is e.g. to Early detection of cancer or to Detection of other internal diseases (e.g. inflammation, injuries, etc.).

The other is endoscopy also for therapeutic purposes used so that tumors, polyps, mucus or secretions, foreign bodies or stones can be removed, bleeding can be stopped, constrictions can be expanded and materials can be introduced.

Furthermore, an endoscopy can also be used prior planning before an operation serve, so that e.g. the exact location and extent of the extent of a tumor can be determined prior to surgery.

Finally, an endoscopy also serves as a possibility for Tumor aftercarein order to be able to identify possible recurrences or other tumor formation at an early stage.

Endoscopy can be used in the following areas: the lungs, esophagus and gastrointestinal tract, chest cavity, abdominal cavity, renal pelvis, bladder and ureter, joints, uterus and fallopian tubes, nose and paranasal sinuses, larynx and ear canal / middle ear.

Where is endoscopy used?

knee

The Endoscopy of the knee is less a reflection of a body cavity or a hollow organ, but rather one Reflection of a joint - namely the knee joint.

Because of this, the S.mirroring of the knee also Arthroscopy called, which comes from the Greek and means something like "look into the joint" (arthros = joint; skopein = look).

The specially made device is accordingly "Arthroscope" called.

The reflection is usually either under local anesthesia of the corresponding knee or in general anesthetic carried out.

After a small incision is made in the knee area, this will rigid, immovable arthroscope inserted into the knee joint after the knee joint has been treated with a special liquid (Ringer's solution) has been filled.

The Knee joint is below appraised and inspectedso that it is possible to define certain Confirm suspected diagnoses and possibly - by introducing additional tools - too treat during the examination.

You can find more information on the subject here Athroscopy of the knee joint

stomach

The Endoscopy of the stomach, also "Gastroscopy“Is called with a flexible endoscope, the so-called "Gastroscope" carried out.

Contrary to what the name suggests, the Gastroscopy usually not only examines the stomachbut on the way there also the esophagus and the one immediately following the stomach Duodenum (Duodenum).

The Indication for an endoscopy of the stomach is usually the when a suspicion of a Disease of the esophagus, stomach or duodenum is suspected and should be confirmed, but also to the To assess the course of an existing disease, one Treatment on site to make or the Follow-up care for a disease perform.

To the most common diseaseswho have had a gastroscopy count Cancers of the Esophagus, stomach and duodenum, ulcers (Ulcers) and Mucosal injuries (Erosions), Bleeding from blood vessels (arterial or venous), Wall openings (Perforations) and Varicose veins in the stomach or in the Esophagus (Varices).

The gastroscopy is usually carried out with the patient under slight sedation, whereby the pharyngeal mucosa is also slightly anesthetized on the surface. The flexible, moveable gastroscope is then inserted through the mouth or nose and then advanced through the esophagus into the stomach.

After inspection of the Esophagus and stomach, where possibly also tissue samples can then be removed using working tools that can be pushed through special endoscope channels finally the duodenum is examinedbefore the gastroscope is pulled out again.

Air is constantly blown in during the exam to allow the esophagus, stomach and duodenum to expand, allowing for better vision.

Generally the Endoscopy of the stomach very low risk, but it can be in very rare cases to Infections, to Intestinal wall penetrations (perforations) or internal bleeding come (if there is an uncontrolled Vascular injury comes).

If the large intestine is also to be examined and assessed, a colonoscopy is also one Colonoscopy- necessary.

Read more on the subject here Gastroscopy

lung

The endoscopy of the lungs is more precisely a reflection of the "passages" of the lower airways, i.e. the windpipe (Trachea) and the branches branching off from it (Bronchial system).

This endoscopic examination of the lungs is therefore also called “bronchoscopy”, and the associated device is called “bronchoscope”.

Here, too, a distinction can be made between rigid and flexible bronchoscopy.

With the rigid bronchoscope, the trachea of ​​an anesthetized patient is examined, assessed and - if necessary - treated with an appropriate tool.

With flexible bronchocsopia, the patient is not completely anesthetized, but only sedated, so that a flexible hose system then passes through the trachea into the ramifications of the airways (bronchi) and these can also be examined.

In general, bronchoscopy is used to clarify a suspicion of certain lung diseases, to make diagnoses, to assess the course of the disease and to carry out therapies.

nose

The Endoscopy of the nose or nasal cavity, also Rhinoscopy called - is an examination procedure in ear, nose and throat medicine in which the doctor to be examined has a Insight into the main nasal cavity can win.

A distinction is generally made between one anterior, middle and posterior nasoscopy, in which different structures of the nose are examined.

In the front mirroring gets through the nostrils especially the lower turbinate and the lower nasal passage judged, but for what usually no endoscope necessary is, but this usually with a so-called Nasal speculum is carried out.

For the medium reflection becomes a rigid or flexible nasal endoscope after a superficial anesthetic of the nasal mucous membrane introduced into the nose, so that then a better and more extensive Assessment of the nasal cavity (the various ducts and shells) is possible.

The rear reflection finds by means of a angled mirror through the mouth instead of the rearmost parts of the nasal cavity to be able to see.

The nasal cavity is examined mostly on Abnormalities in the mucous membrane (Swelling, redness, inflammation) Polyps, other benign or malignant tumors or on Shape variants or a Inclination of the nasal septum.

Risks

Because endoscopy is a so-called "minimally invasive procedure" (= an procedure with minor tissue damage), there are significantly fewer risks than with a conventional surgical procedure.

Endoscopic interventions for diagnostic or therapeutic purposes therefore have the advantage that the burden on the patient is significantly lower and healing or recovery progresses faster, so that a shorter hospital stay is possible and better cosmetic results can be achieved.

The risks and complications that are nevertheless possible - but occur in very low percentages - include above all infections, internal bleeding, organ punctures (Perforations) and the cardiovascular disorders.

In order to avoid that pathogens are introduced into the body with the introduction of the endoscope and its tools, an antibiotic can be given in advance in some cases (risk patients).

Internal bleeding can occur if blood vessels are injured during the examination, but these can usually be brought to a standstill immediately.

The same applies to organ punctures, which can be sewn again with the appropriate tool during the examination.

procedure

How an endoscopy works depends entirely on the examination site (e.g. gastrointestinal tract, lungs / bronchi, nasal cavity, knee joint, etc.).

If the Endoscope over the mouth, care should be taken in advance that dentures and Piercings in the mouth area can be removed.

If an examination of the gastrointestinal tract is carried out, the patient must appear sober for the appointment and the Bowel should be completely emptied be.

The endoscopy takes place in either one brief sedation (mostly) or in one general anesthetic (only in some cases).

The endoscope is then about the natural body orifices (Mouth, nose, anus etc.) or over one small skin incision (e.g. in the case of a knee-endoscopy, laparoscopy, etc.) introduced into the body.

From the investigation self, gets the / the The patient usually has absolutely nothing to do with.

The doctor now has the option during the Endoscopy “only” the relevant organ or the to examine the corresponding body cavity, he can but also take tissue samples and carry out a treatment using special tools.