What is endoscopy?
enˇdosˇcoˇpy (?n'd?-sk?p') n. Examination of the interior of a canal or hollow organ by means of an endoscope.
-From: The American HeritageŽ Stedman's Medical Dictionary. Houghton Mifflin Company.
Endoscopy literally means to "look into." Gastroenterologists have specialized in the technique of endoscopy for decades, initially practicing with rigid instruments which could be passed only for a limited distance into the intestinal tract via the mouth or anus. Advances in technology led to the development of flexible fiberoptic instruments in the 1970's and video-based instruments in the 1980's which allow high quality optical images of the interior of the esophagus, stomach, and duodenum (though the mouth) and the colon, or large intestine, and ileum (last segment of small intestine) through the anus.
Modern gastrointestinal endoscopy is painless when performed under procedural sedation. We enter and leave the body through natural openings, making endoscopy a minimally invasive procedure. Endoscopy is used both for diagnosis and for treatment. For example, during a colonoscopy a polyp may be discovered (diagnosed) and then immediately removed (treated) using endoscopic surgical techniques.
The most recent major technological breakthrough in our field has been the development of the Given Imaging capsule endoscope, or "pill camera," which allows us to view the entire length of small intestine in most cases. The endoscopy capsule consists of a digital camera inside of a vitamin-sized plastic "pill" which contains a flashing light source, radio transmitter, and battery. The small bowel endoscopy capsule takes two digital photographs each second and transmits them in a typical jpg format to a digital recorder worn outside the body. The capsule passes out of the body naturally and the recorder, which typically contains about 50,000 images is returned to the clinic for review by the gastroenterologist. Capsule endoscopy, while used in our practice for examination of the small intestine, has applications in the esophagus and colon as well.
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What does a flexible endoscope look like?
Flexible endoscopes are used for upper endoscopy (EGD) and colonoscopy. This photograph of Olympus flexible endoscopes shows the narrow flexible tube which we pass into the body. The insertion tube is about the diameter of a pen. The tip of the insertion tube contains a video camera (similar to a VCR) and a lighting system, which brings light from an external 300 watt xenon lamp to the inside of the body via fiberoptic cables, which provide very bright illumination without exposing the body to the heat generated by the light supply. The tip is steered by a series of cables connected to the control handle, which is operated by the doctor. Images are viewed on computer monitors by the doctor and his assistants, and digital images of key findings are recorded.
An upper endoscope insertion tube is 100 cm (3.2 feet) in length. A colonoscope is 170 cm (5.6 feet) long.
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