Surgery Lecture - 12 Endoscopy

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    Endoscopy ranks as one of the mostEndoscopy ranks as one of the mostimportant technical advances inimportant technical advances inmedicine of the last few decades. Notmedicine of the last few decades. Notonly has it added a new precision toonly has it added a new precision togastrointestinal and pancreaticobiliarygastrointestinal and pancreaticobiliarydiagnosis, particularly when used indiagnosis, particularly when used inconjunction with cytology or biopsy, butconjunction with cytology or biopsy, butit has also been one of the earliestit has also been one of the earliesttools, along with interventionaltools, along with interventionalradiological techniques, in theradiological techniques, in theadvances of minimally invasive therapy.advances of minimally invasive therapy.    There   are two types of endoscopy Rigid -Proctoscope-Sigmoidoscope-Thoracoscopy-Cystoscope-Laparoscopy-Athroscopy Flexible -Esofagogastroscopy-Duodenoscopy-Colonoscopy-Sigmoscopy-Bronchscopy    The modern flexible endoscope hasThe modern flexible endoscope hasthe following features:the following features: Light source – in the handle with a fibreoptic bundle for Light source – in the handle with a fibreoptic bundle for the transmission of light to the area under investigation.the transmission of light to the area under investigation.Viewing system – Photons impacting on this areViewing system – Photons impacting on this areconverted into a digital video signal which can then beconverted into a digital video signal which can then beviewed on a screen. The video image can easily beviewed on a screen. The video image can easily bestored for use in teaching and can be enhanced bystored for use in teaching and can be enhanced byelectronic processing.electronic processing.Control and manipulative elements which are stillControl and manipulative elements which are stillmechanical and allow the tip to be defected andmechanical and allow the tip to be defected andinstruments such as snares, stents, biopsy forceps,instruments such as snares, stents, biopsy forceps,balloons and baskets to be passed along a workingballoons and baskets to be passed along a workingchannel.channel.    Preparing patient for examinationPreparing patient for examination The patient must have an empty stomach; nothingThe patient must have an empty stomach; nothingby mouth for 6 h beforehand is usually sufficient.by mouth for 6 h beforehand is usually sufficient.Pharyngeal anesthesia to blunt the gag reflex isPharyngeal anesthesia to blunt the gag reflex isachieved with benzocaine or lidocaine.achieved with benzocaine or lidocaine.The patient is also given intravenous sedation andThe patient is also given intravenous sedation andis monitored during the procedure with bloodis monitored during the procedure with bloodpressure determinations, pulse oximetry andpressure determinations, pulse oximetry andelectrocardiography.electrocardiography.
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