Endoscopy

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In an endoscopy, a body cavity (such as the abdomen, knee joint) or a hollow organ (such as the intestine, lungs) is examined from the inside with the help of an endoscope. The endoscope consists of a flexible rubber hose or a metal tube with a light source, lenses and a camera. During the endoscopy, small interventions can also be carried out and tissue samples (biopsies) can be taken. Find out more about the possibilities of an endoscopy.

What is an endoscopy?

With endoscopy, you take a look inside body cavities or organs. To do this, the doctor inserts an endoscope, consisting of a flexible rubber hose or a solid metal tube. A lens with magnification and a small camera are attached to the front end. The images recorded from inside the body are usually transferred to a monitor and saved. In order to make the examination area clearly visible, an endoscope also has an air pump, a light source (cold light), and a rinsing and suction device. Special instruments with which tissue samples can be taken can be introduced via integrated channels.

With the help of endoscopy, many organs and body cavities can be examined, for example:

Lungs and chest: The endoscopic examination of the lungs is called thoracoscopy, and that of the chest is called mediastinoscopy.
Bronchi: Endoscopy of the bronchi is called bronchoscopy.
Gastrointestinal tract: The endoscopies of this organ system are called gastroscopy (gastroscopy), colonoscopy (colonoscopy), rectoscopy (rectoscopy) and proctoscopy (rectoscopy). The last four are also summarized under the term colonoscopy.
Abdominal area: The abdominal area with all its organs is examined using laparoscopy (laparoscopy).
Joints: The endoscopy of a joint (e.g. knee) is called arthroscopy.

When do you do an endoscopy?

An endoscopic examination is always necessary when the doctor cannot make a reliable diagnosis with the naked eye or with other imaging methods such as x-rays or computed tomography. The doctor's direct look inside an organ or a body cavity and the possibly necessary biopsy (tissue removal) for a histological examination help to make the correct diagnosis. Small operations such as the removal of intestinal polyps are also possible as part of an endoscopic examination.

An endoscopy is done:

to diagnose or monitor the progress of various diseases (such as gastric ulcer, meniscus injuries, pneumonia, ovarian cysts)
if a malignant change in tissue is suspected (e.g. colon cancer, stomach cancer)
for carrying out small surgical interventions (e.g. removal of an inhaled foreign body from the lungs, tissue removal)

What do you do with an endoscopy?

Thoracoscopy and mediastinoscopy (endoscopy of the lungs or chest) are performed under general anesthesia. The endoscope is inserted here through a small incision in the tissue.

In a bronchoscopy (endoscopy of the bronchi), a tube-shaped endoscope is pushed through the mouth into the lungs. This can be done either under general anesthesia or under local anesthesia; In any case, the patient is injected with a sedative beforehand.

In gastroscopy (gastroscopy), the doctor inserts the endoscope into the stomach through the mouth and esophagus. Anesthesia is not absolutely necessary for this. However, inserting the flexible tube through the mouth and throat can trigger a gag reflex in sensitive patients. Local anesthesia in the oropharynx can counteract this. If necessary, the patient is also given a sedative or a brief general anesthetic.

During colonoscopy (colonoscopy), the endoscope is inserted through the anus, optionally without anesthesia, with the administration of a sedative or a light anesthetic. Before the examination, the bowel is emptied using a laxative.

Rectoscopy and proctoscopy (rectoscopy) are also performed through the anus. Although they are uncomfortable for many patients, in most cases they can be tolerated well without anesthesia. Special preparation is usually not necessary.

A laparoscopy (laparoscopy) is performed under general anesthesia. After making a tiny incision, the endoscope is inserted next to the navel and the abdomen is inflated to allow the surgeon a clear view of the interior. Gall bladder operations, appendectomy and the surgical removal of adhesions in the abdominal cavity are now almost exclusively performed as part of a laparoscopy. In the gynecological area, ovarian cysts are removed using a laparoscopy. In the case of chronic pelvic pain that cannot be explained with normal examination methods, this form of endoscopy is used for diagnosis.

Arthroscopy is the method of choice for procedures on the knee, shoulder, ankle and wrist.The endoscopy is mainly used for therapeutic purposes.

In some cases, endoscopy, such as gastroscopy, colonoscopy, and laparoscopy, can only be performed on an empty stomach. Blood-thinning medication must be discontinued well in advance of the examination.

What are the risks of an endoscopy?

The following complications occur in rare cases during endoscopy:

Bleeding in the area of the removed tissue (but can usually be stopped during the examination)
Infections
Respiratory or cardiovascular disorders when taking sedatives or painkillers

What do I have to consider after an endoscopy?

How much time you need to plan for the endoscopy and whether you can return to work on the same day after an outpatient procedure should be discussed in advance with the attending physician. He will also explain what to look for in the days after the endoscopy. If you have been given a short anesthetic for the examination, you are not allowed to go home alone afterwards, but have to be picked up and should be observed throughout the day - in the (rare) event that after-effects or complications of the endoscopy occur.

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