Endoscopy

The endoscopy is a method of exploration and Medical imagery which makes it possible to visualize the interior ( endon in Greek) of the conduits (digestive tract) and of the cavities of the body, and to light them using an external light whose rays were formerly reflected by the walls of the apparatus ( E. with external light of Désormaux ) or currently, either using a Endoscope or by the ingestion of a Vidéocapsule of the size of a gélule.

The endoscope is composed of an optical tube provided with a lighting system and small video cameras which thus can retransmettre the image on a screen.

The endoscopy can be used, either for the diagnosis, or to treat a disease (operational endoscopy). It is about a generic term which recovers specific examinations by body. Thus, the bronchoscopy is the exploration of the bronchi, the coloscopy, that of the colon, the cystoscopy, that of the bladder, etc

The endoscopies tube are done by the natural ways when that is possible, by incision if not (surgical Endoscopie).

History

The endoscopy (the term is introduced into the French language since 1866 after the invention by Desormeaux of the first endoscope in 1852) saw its technical system (the endoscope) improving in the years 1930 with the development of a tube semi-flexible device intended to study the interior of the stomach (gastroscope). Towards the end of the year 1950, the introduction of glass fiber beams leading the light (fiberoptics) made it possible to manufacture entirely flexible endoscopes called fribroscopes, widening considerably the employment opportunities of this technique. In the years 1960, arthroscopies (exploration of the articulations) are carried out; the coelioscopy (exploration of the abdomen) also develops in gynecology.
The appearance of miniaturized cameras and progress of the video in years 1980 finally opened the way with the endoscopic surgery while making it possible to visualize handling on a screen.

The Endoscope

The endoscope is a tube provided with a lighting system. There are 2 types. The rigid endoscope is made of a metal tube from 5 to 8 millimetres in diameter and 15 to 30 centimetre from length. It is especially used for the exploration of the articulations (arthroscopy), of the bladder (cystoscopy), of the abdominal cavity (laparoscopy or coelioscopy). The flexible endoscope or fibroscope, as for him consists of fiberoptics leading the light. It is longer than the rigid endoscope and makes it possible to explore bodies such as the bronchi, the esophagus, the stomach, the duodenum or the colon. The endoscopes can be equipped with small cameras which retransmettent the image on a screen. Accessories are sometimes associated with the endoscope to carry out surgical acts or taking away: grips to seize and withdraw the foreign body or of the samples of fabrics, scissors to cut fabrics, brushes to take cells, lace to catch polyps…

Uses

The endoscopy can be used either to establish a diagnosis (endoscopy diagnoses), or to treat a disease or a traumatism (operational endoscopy). The endoscopies are done, when that is possible by the natural ways (by the mouth for the stomach and the bronchi, by the nostrils for the nasal fossae and the sines; by the anus for the examination of the colon); if not, an incision makes it possible to penetrate in certain cavities of the organization. according to the technique used, the gestures are carried out under local anesthesia or general.

Scopes of application

Otorhinolaryngology

Carried out under general anesthesia, the direct laryngoscopy makes it possible to visualize the larynx and the vocal cords. The rhinofibroscopy allows the examination of the nasal fossae, the larynx and the pharynx. Lastly, the purpose of the sinuscopy is to observe the maxillary sinuses nasal and to appreciate the state of the mucous membrane. A local aneshesy precedes the examination.

Pneumology

The bronchial fibroscopy makes it possible to observe the trachea and the bronchi. The examination is done under local anesthesia or general. The pleuroscopy explores the pleural cavity (space between 2 layers of the plèvre) under local anesthesia or general.

Gastro-enterology

High digestive endoscopy

  • the endoscopy œso-gastro-duodénale' is carried out with jeun under simple local anesthesia of the Pharynx, sometimes associated with the catch of a Anxiolytique, seldom under general anesthesia. It requires a flexible fibroscope provided at its end with a CCC color and a cold light. It is about an unpleasant but painless examination. It makes it possible to explore the walls œsophagiennes, gastric and duodénales, like carrying out taking away (Biopsie S of the mucous membrane or a lesion and also of gastric liquid,…) and if required to practice therapeutic gestures (Hémostase, ablation of small tumors, etc). Its principal indications are the diagnosis and the follow-up of the gastro-duodénaux ulcers and cancers, the primitive lesions œsophagiennes (cancers) or secondaries with the Reflux gastro-œsophagien, or the assessment of a Dysphagie or a digestive hemorrhage.

Low digestive endoscopy

  • the anuscopy , realized under direct control of the sight, is not an endoscopy in a strict sense term.
  • the rectoscopy is carried out without anesthesia using a rigid tube, with or without rectal injection preparer. It allows the exploration of the rectal mucous membrane on a short distance.
  • the rectosigmoidoscopy or short coloscopy is carried out with a flexible tube, without anesthesia. It allows the exploration of the rectum and the final part of the colon (sigmoid).
  • the total coloscopy finally is carried out after mode without residues and total rectal injection colic. It is carried out under general anesthesia, more rarely under simple sedation by anxiolytic. It allows the exploration of the totality of the colon and the final portion of the Iléon. The coloscopy is indicated in complement of the clinical examination in the assessment of a digestive bleeding low (Rectorragie, Melæna), for tracking on risk factors of the tumors benign colics (polyp S, Adénome S) and malignant (Cancer of the colon) or of inflammatory affections of the intestine (Maladie of Crohn, hemorrhagic Rectocolite). It allows finally the realization of gestures diagnostic aiming (Biopsie S) or therapeutic (ablation of polyps,…). The coloscopy involves risks (lesion of the wall colic, bad tolerance of the general anesthesia, etc).

Exploring coelioscopy

  • the Coelioscopy or Laparoscopie is carried out under General anesthesia. It consists in insufflating an inert gas (carbon dioxide) in the abdominal cavity, then to introduce a camera there. It allows the exploration of the whole of the abdominal cavity, of the Péritoine as well as surface of the internal organs (liver, gall bladder, intestinal walls, internal genitals at the woman,…), and if need be to carry out a gesture with diagnostic or therapeutic aiming. The post-operative tolerance is very satisfactory.

Obstetric gynecology/

The Coelioscopie allows the observation of the internal genitals of the woman. She implies a General anesthesia. The Hystéroscopie makes it possible to observe the channel of the cervix, the cavity of the uterus and the mucous membrane which papers it (the Endomètre). She is carried out under Local anesthesia or general if an intervention is envisaged. The Foetoscopie (direct examination of the fetus), rare, is made at the hospital under General anesthesia.

Urology

The Cystoscopie is the examination of the walls of the Vessie. It is practiced without anesthesia at the woman and under Local anesthesia at the man. When it is carried out with an aim Thérapeutique, it implies, for the two sexes, a loco-regional Anesthésie by Péridurale or Rachianesthésie, or a General anesthesia. The Urétéroscopie is the endoscopic examination of a Uretère, or of both Uretère S. It is in general practiced under General anesthesia or loco-regional Anesthésie. The Néphroscopie is the endoscopic examination of the Bassinet. It is in general practiced under General anesthesia or loco-regional Anesthésie.

Rhumatology

L `Arthroscopie is the direct observation of the interior of a large articulation. It is made under Anesthésie, general generally.

See too

  • Coelioscopy
  • Coloscopie
  • Cystoscopie
  • Fibroscopie
  • Hystéroscopie
  • Laparoscopie
  • Pleuroscopie

External bonds

  • Endoscopy
  • Medical imagery
  • digestive Endoscopy
  • digestive Endoscopy
  • Endoscopy occulaire
  • medical Corpus of the medical college of Grenoble
  • surgical Endoscopy
  • French company of Digestive Endoscopy (SFED)
Video:
  • modern Endoscopy; extract emission ORTF (April 1969) (File INA)

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