A visualising technique enabling the operator to examine the internal organs with the minimum of disturbance or damage to the tissues. The procedure has transformed the management of, for example, gastrointestinal disease. In chest disease, ?breoptic bronchoscopy has now replaced the rigid wide-bore metal tube which was previously used for examination of the tracheo-bronchial tree.
The principle of ?breoptics in medicine is that a light from a cold light source passes down a bundle of quartz ?bres in the endoscope to illuminate the lumen of the gastrointestinal tract or the bronchi. The re?ected light is returned to the observer’s eye via the image bundle which may contain up to 20,000 ?bres. The tip of the instrument can be angulated in both directions, and ?ngertip controls are provided for suction, air insu?ation and for water injection to clear the lens or the mucosa. The oesophagus, stomach and duodenum can be visualised; furthermore, visualisation of the pancreatic duct and direct endoscopic cannulation is now possible, as is visualisation of the bile duct. Fibreoptic colonoscopy can visualise the entire length of the colon and it is now possible to biopsy polyps or suspected carcinomas and to perform polypectomy.
The ?exible smaller ?breoptic bronchoscope has many advantages over the rigid tube, extending the range of view to all segmental bronchi and enabling biopsy of pulmonary parenchyma. Biopsy forceps can be directed well beyond the tip of the bronchoscope itself, and the more ?exible ?breoptic instrument causes less discomfort to the patient.
Fibreoptic laparoscopy is a valuable technique that allows the direct vizualisation of the abdominal contents: for example, the female pelvic organs, in order to detect the presence of suspected lesions (and, in certain cases, e?ect their subsequent removal); check on the development and position of the fetus; and test the patency of the Fallopian tubes.
(See also ENDOSCOPE; BRONCHOSCOPE; LARYNGOSCOPE; LAPAROSCOPE; COLONOSCOPE.)
Examination of a body cavity – for example, PLEURAL CAVITY, GASTROINTESTINAL TRACT, BILE DUCT and URINARY BLADDER – using an ENDOSCOPE in order to diagnose or treat a disorder in the cavity. The development of endoscopy has reduced the need for major surgery, as many diagnostic procedures can be performed with an endoscope (as can MINIMALLY INVASIVE SURGERY (MIS)). The development of ?bre optics (the transmission of light along bundles of glass or plastic ?bres) has greatly advanced the practice of endoscopy and hospitals now routinely run endoscopy clinics on an out-patient basis, often without the necessity for a general anaesthetic.... endoscopy
(VCE) an investigation for visualizing the intestinal lining (mucosa). A capsule containing a miniature digital video camera is swallowed by the patient and passively propelled through the intestine by peristalsis. The images are uploaded to a computer for subsequent analysis. Various capsules are available for investigation of oesophageal, small-intestinal, and colonic disorders. The commonest in use is the small-intestinal capsule, for investigation of obscure gastrointestinal bleeding, recurrent iron-deficiency anaemia, or in cases of suspected Crohn’s disease, coeliac disease, or small-bowel tumours.... video capsule endoscopy
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