It can also be inserted into the body directly through a small incision through the skin to look, for example, into the abdomen or pelvis. It can also be inserted through other areas or orifices to inspect other organs. Once done, biopsies (samples of live tissues) can be taken and sent to labs for a more accurate diagnosis. This process can also be used to remove foreign bodies, abnormal growths or tumours, check for ulcers and for closing off abnormal or leaking blood vessels.
Different names are applied to endoscopic procedures depending on which part of the body is being visualised. Examples are given below:
1. OGD (Oesophago-gastro-duodenoscopy): also known as an upper GI endoscopy or gastroscopy since the stomach is often the main part that needs to be seen. In this test, the flexible scope in swallowed while the patient is lightly sedated, to visualise the food pipe (oesophagus), stomach, and upper past of the small bowel (duodenum). This can also be used to removed foreign bodies which are accidentally swallowed.
2. ERCP (Endoscopic Retrograde Cholangiopancreatography): in this procedure, a side viewing duodenoscope is passed into the upper part of the small bowel as described above and a catheter is pushed further into the bile duct. Then a contrast dye is injected into the bile duct and X-ray pictures taken to see clear images of the bile duct system up to the gall bladder and pancreatic ducts. This is useful to remove gallstones or dilate the ducts in the presence of benign or malignant blockages. See also "ERCP" separately.
3. Proctoscopy: a small metal tube is past through the anus to see the lower rectum only and is useful to visualised piles (haemorrhoids).
4. Sigmoidoscopy: either a rigid or flexible tube is inserted through the anus to visualise the lower rectum but far more of the rectum is seen than with a proctoscope. This is useful for taking biopsies of masses and diagnosing other rectal conditions.
5. Colonoscopy: a flexible tube is passed through the anus to visualise almost the whole colon (large bowel) and because of this, more preparation is required with emptying of the bowel and is technically a more difficult procedure.
6. Bronchoscopy: a flexible tube is passed into the airways through the mouth and is used to visualised the trachea (main airway to the lungs) and smaller airways such as the bronchi. Foreign bodies which are accidentally inhaled can be removed in this way.
7. Hysteroscopy: a tube is passed through the vagina, cervix and into the inside of the uterus (womb). This can be useful in diagnosis and treatment of various conditions in women.
8. Laparosopy: a rigid tube is passed through the abdominal wall into the abdomen or pelvis to view the appropriate organs. Air is blown into the cavity to make inspection easier, but there may be some pain after this procedure because of the stretching effect of the air on the abdominal wall and organs inside. A diagnosis can be made and certain corrective procedures may be carried out at the same time.
9. Cystoscopy: a scope is passed through the penis in men or through the urethral opening above the vagina in women into the urethra (tube connecting the urinary bladder to the outside), and then into the bladder itself. The bladder can be inspected for masses or signs of disease and biopsies taken or corrective surgery done with the cystoscope. Variations of this instrument enable the surgeon also to pass a camera through the ureter (tube connecting the kidney to the bladder) to the kidney itself. This is very useful in treating or removing kidney stones. See also "Cystoscopy" separately.
10. Arthroscopy: a tube is passed into a joint such as a knee, shoulder, elbow, ankle or wrist to visualise the structures within for a diagnosis or corrective surgery. See also "Arthroscopy" separately.
11. Nasendoscopy: a small flexible tube is passed into the nose to inspect the nasal passages, sinuses and back of the throat.
Generally, these are safe and effective procedures. But as with all invasive tests or surgery, there are risks. These include, infection, haemorrhage (bleeding), rupture of the intestines or any other tube into which a scope is passed and damage to the organ being viewed or neighbouring organ in the vicinity.
This is usually done as a day case procedure, with mild sedation, local or a general anaesthetic depending on what is suspected and what needs to be visualised and whether a rigid or flexible scope is being used. Other incisions may be required for further surgical procedures such as an operation in the abdomen or pelvis where other instruments such as forceps may be required. This is generally know as keyhole surgery.