Endoscopy
Endoscopy is a medical procedure that involves using a long thin tube with a light and special a camera at the head, called the endoscope to inspect the inside of your body’s hollow organs, most commonly the stomach and large intestine, without performing major surgery. During the procedure, the scope captures and displays the real time picture of your digestive tract to a color TV monitor. There are many different types of endoscopies to look at different parts of your body, depending on your needs and your symptoms.
Endoscopy is usually recommended for patients who have symptoms such as abdominal pain, constipation, diarrhea, blood in stool, monitoring or follow-up of polyps and routine cancer screening etc. In addition, when an abnormality such as a lump or growth is detected, your doctor can take a biopsy (removal of some tissue samples) to detect or exclude the presence of cancer.
Other than diagnostic purposes, your endoscopist can also perform a number of curative procedures with the endoscope. If a polyp is encountered during the investigation procedure, the endoscopist can use a special instrument to excise the polyp and send the specimen to the laboratory for a pathology report. In addition, there are other advanced endoscopic procedures to diagnose and treat specific conditions such as endoscopic ultrasound (EUS), endoscopic submucosal dissection (ESD) and per- oral endoscopic myotomy (POEM). These procedures are all highly specialized and require specific operative instruments to complete the task.
Every medical procedure has some risks and endoscopic procedures are generally considered safe. Commonly encountered risks include bleeding, adverse reaction to anesthetic medications and perforation of the intestine. In general, the risk of perforation is about 1 in 10000 in gastroscopy and 1 in 1000 in colonoscopy. Contact your doctor straight away if you have any symptoms that worry you after endoscopy.
Gastroscopy
Also known as upper endoscopy, this procedure involves inserting a flexible endoscope through the mouth to examine the esophagus, stomach and duodenum.
Gastroscopy is usually done when patients complain of abdominal pain, indigestion, nausea, vomiting or weight loss. The endoscope allows the endoscopist to look for ulcers, tumors, and inflammation in the upper gastrointestinal tract. If an abnormality is detected, a biopsy or tissue sample is usually taken for further tests. It is also a routine to check for the presence of Helicobacter Pylori and it is also possible for polyps to be removed at the same time during the procedure.
Colonoscopy
Colonoscopy is an endoscopic exam which the endoscopist inserts a flexible endoscope that is about the size of your finger through your anus to examine your entire large intestine. This examination helps your doctor to look for causes of abdominal pain, blood in stools, constipation, diarrhea and screening for colon cancer.
This procedure is done under monitored anesthesia most of the time and allows your doctor to look for the presence of ulcers, polyps or even cancer. Most of the polyps that are detected are feasible for removal during the same session and abnormal tissue can be sampled for further tests.
Endoscopic Ultrasound
As the name implies, endoscopic ultrasound combines endoscopy with ultrasound. This procedure is similar to endoscopy, where the instrument is inserted through the mouth or anus, and an ultrasound examination is performed from the inside of the digestive tract. The examination is targeted at detecting submucosal pathologies, such as leiomyoma, gastrointestinal stromal tumour(GIST) and even other nearby organs and tissues. High frequency sound waves from the ultrasound probe of the endoscope can produce detailed images of the digestive tract and surrounding organs, including the gallbladder, liver and lymph nodes. Sometimes when a tissue sample is required outside the gastrointestinal tract, the ultrasound image can guide a thin needle through the endoscope to obtain a biopsy.
Endoscopic Submucosal Dissection (ESD)
Endoscopic submucosal dissection (ESD) is a minimal invasive procedure that uses an endoscope and specialized instruments to remove early cancers, pre- cancerous lesions or large polyps found in the esophagus, stomach, and large intestine.
ESD is usually done under general anesthesia or monitored anesthetic care. The main advantage of ESD is that there is no need for traditional open surgery to resect the lesion together with part of your stomach or intestine and it offers a much quicker and less painful recovery without any visible wound at the skin. In most cases, patients need to stay in the hospital after the procedure for 1 to 2 nights and can resume fluid diet the next day.
Per-oral Endoscopic Myotomy (POEM)
Per-oral endoscopic myotomy (POEM) is a recognized standard treatment specifically for the condition called achalasia. In achalasia, the lower esophageal sphincter (LES) which is the ring of muscle between the esophagus stomach does not relax, food will not be able to enter the stomach and patients will have a persistent hold up sensation at the lower chest.
POEM is procedure where an endoscope with specialized instruments cut the muscle of the LES from inside the esophagus. As a result, there will be no surgical wounds on the abdomen and recovery will be faster and less pain compared to traditional surgery.