An endoscopy is a minimally invasive medical procedure, performed by specially trained doctors, to examine the insides and linings of the body’s organs.
Variations exist in the way an endoscopy is performed, depending on the organ being investigated, and the purpose of the procedure. Typically, it involves the insertion of an endoscope into the body. The site of insertion depends on the type of endoscopy being done. An endoscope is a long, slim, rigid or flexible, tube-like instrument with a light and small camera attached at one end. During an endoscopy, the doctor moves the scope through an organ cavity, while the camera projects real-time images of the organ onto a monitor, so physicians can look at the organ’s interior more clearly.
When might you need an Endoscopy?
An endoscopy can be warranted for the following reasons:
- Diagnosis – For further investigation of abnormal symptoms to determine the presence of any underlying disease (e.g., imaging, biopsy).
- Treatment – Used to aid certain medical proceedings (e.g., tumour removal, laser therapy, medication administration).
- Screening – Recommended by clinicians for select patient groups (e.g., colonoscopy for screening of colorectal cancer).
What are the Different Types of Endoscopies?
There are many kinds of endoscopies, each developed specifically to look at a distinct part/area of the body. The table below gives a brief overview of the various types of endoscopies available, and when they might be used.
| Endoscopy Type | Purpose |
| Anoscopy:
Anoscope inserted through the anus to look at the anus and/or rectum. |
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| Arthroscopy:
Arthroscope inserted via a small opening over the joint of interest. |
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| Bronchoscopy:
Bronchoscope inserted through the mouth to examine the trachea and lungs. |
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| Colonoscopy:
Colonoscope inserted into the anus to see the entire length of the colon and rectum. |
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| Colposcopy:
Colposcope placed at vagina opening after dilation with a specialized tool, to look inside the vagina and cervix. Scope is not inserted. |
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| Cystoscopy:
Cystoscope inserted into the urethra to see the urethra and bladder. |
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| Oesophagoscopy:
Oesophagoscope inserted through the mouth to look in the esophagus. |
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| Flexible Sigmoidoscopy:
Sigmoidoscope inserted into the anus to see inside the sigmoid colon. |
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| Gastroscopy:
Gastroscope inserted via the mouth to examine the oesophagus, stomach, until the beginning of the small intestines. |
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| Hysteroscopy:
Hysteroscope inserted through the vagina and cervix to look inside the womb. |
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| Laparoscopy:
Laparoscope inserted into an opening in the abdomen to see inside the belly and pelvis. Additional small cuts may be made to insert surgical tools. |
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| Laryngoscopy:
Laryngoscope inserted through the nose/mouth to look at the voice box, vocal cords, and throat. |
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| Mediastinoscopy:
Mediastinoscope inserted into an opening in the breastbone to see the mediastinum. |
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| Neuroendoscopy:
Neuroendoscope inserted through the mouth, nose, or an opening in the skull to access certain parts of the brain. |
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| Proctoscopy:
Proctoscope inserted into the anus to look inside the rectum and anus. |
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| Thoracoscopy:
Thoracoscope inserted into a small opening made in the chest to examine the pleura. |
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| Ureteroscopy:
Ureteroscopy inserted in the urethra to look into the ureter and kidneys. |
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The table above is not exhaustive, and might not include all forms of endoscopies, and their purposes.
Advancements in Endoscopies
Developments in technology have brought about newer methods of endoscopy such as:
Wireless capsule endoscopy
In this technique, the patient is required to swallow a capsule, about the size of a large vitamin pill, that contains a camera, light, batteries, a radio transmitter, and an antenna.
As the capsule passes through the body, pictures of the interior of the oesophagus, stomach, and small intestines are taken. The images are then transmitted to a recording device worn around the patient’s waist. Once completed, the recorded images may be downloaded onto a computer for the doctor to examine.
The capsule is disposable and typically stays in the body for about 8 hours. It is most often used to investigate small intestinal bleeding.
When doing this procedure, patients should not come into close contact with an MRI machine or schedule any MRI investigations.
Advantages:
- Non-invasive unlike conventional endoscopic methods.
- Does not require sedation and is painless.
- Able to reach parts of the small intestine that traditional endoscopies cannot.
Disadvantages:
- Can be difficult to swallow and pass out the capsule.
- Possibility of the capsule getting stuck in narrower areas in the bowels, causing a blockage.
- This method cannot be used to obtain a biopsy, or to carry out any treatments (e.g., polyp/tumour removal).
Virtual Endoscopy
This technique makes use of multiple computed tomography (CT) scans of a part/area of the body that are combined by a computer to give a more complete picture. This method is still being studied, and not routinely recommended.
Advantages:
- Non-invasive unlike conventional endoscopic methods.
- Does not require sedation and is painless.
Disadvantages:
- Exposes patient to radiation.
- Expensive
- Traditional endoscopy might still be warranted subsequently (e.g., for polyp/tumour removal).
In conclusion, there are many different endoscopies available. Your clinician will discuss with you which kind of endoscopy you will need based on your condition.
