Endoscopy is a medical procedure that allows the doctor to see inside the body without having to perform a major surgical procedure. An endoscope (fibroscope) could be a long one, flexible tube with a lens on one end and a video camera on the other. The end with the lens is inserted into the patient body. Light passes through the tube (via fiber optic bundles) to illuminate the area, and the video camera magnifies the area and projects it onto a television screen, so the doctor can see what’s there. The endoscope is usually inserted through one of the natural body openings such as the mouth, urethra or anus. Specially designed endoscopes are used to perform simple surgical procedures such as B. Locating, harvesting or removing tumors from the lungs and digestive tract. Locate and remove foreign objects from the lungs and digestive tract. Take small tissue samples for diagnostic purposes. (Biopsy). Removal of stones from the bile duct. Placement of tubes (stents) through blockages in the bile duct, esophagus, duodenum, or colon.
Range of Endoscopes
Endoscopes have been designed for many parts of the body. Each has its own name depending on the body part being examined, such as:
Bronchoscope – inserted into the windpipe (trachea) to examine the lungs.
Colonoscope: Inserted through the anus to examine the large intestine (intestines).
Gastroscope: Inserted into the esophagus to examine the stomach.
Duodenoscope: Inserted through the stomach into the duodenum to inspect and perform the bile duct and/or pancreatic duct,
called ERCP (endoscopic retrograde cholangiopancreatography).
Hysteroscope: Inserted through the cervix to examine the uterus.
Cystoscope and Ureteroscope: Inserted through the urethra to examine the bladder and ureters in the doctor’s office. Others require a visit to the hospital or outpatient surgery center and may require general anesthesia. Endoscopies are generally painless, although they can still cause some discomfort.
Compared to the stress on the body of a full surgical procedure, endoscopy is simple, low-risk and inexpensive.
Other advantages are:
- No scar, since a natural body opening is used.
- Fast recovery time
- Less time in the hospital
- Hospital time is often not required, as the procedure is performed in the doctor’s room.
Prior to your endoscopy, your doctor will discuss your medical history, including allergies and current medications. These factors can affect operation.
The exact procedure depends on the type of endoscopy and the choice of anesthesia. You may be given sedation or general anesthesia. The endoscope is inserted through a natural opening. The doctor can easily make a diagnosis. You can also take a tissue sample (biopsy) for later analysis in a laboratory.
Alternatively, your doctor may perform minor surgery at the same time. For example, they can place a stent through a blocking tumor or remove a stone from a bile duct. When the endoscopy is complete, the endoscope will be removed.
Immediately after the endoscopy
After the endoscopy, you can wait:
- in most cases you will be kept under observation for about an hour.
- If you had general anesthesia, you will be monitored longer.
- Some types of endoscopic procedures, such as B. ERCP, may require an overnight stay in the hospital to make sure everything is okay.
- You may be given pain medication if necessary.
- You need someone to drive you home or take a cab.
- Due to the effects of drugs during surgery.
Possible complications of endoscopy include:
- Perforation of an organ
- Excessive bleeding (hemorrhage)Infection.
- Allergic reaction to anesthesia
- Inflammation of the pancreas (pancreatitis) after ERCP.
Self-care at home
Self-care depends on the type of endoscopy you do. Consult your doctor for advice, but general recommendations include:
- Most patients can resume normal activities within 24 hours to a few days.
- Contact your doctor or go to the hospital if you have severe abdominal pain, vomiting, blood, or black bowel.
- Long-term perspective
- Recovery time after endoscopy is short, usually a few hours to a day or so.
Alternatives to endoscopy
The main alternatives to endoscopy can be x-rays for diagnostic procedures or open surgery for treatment procedures. Diagnosis of the bowel can be made by swallowing X-ray contrast media (barium) or by injecting it into the rectum.
Disadvantages of X-ray procedures include:
- An unpleasant taste or discomfort.
- Biopsies cannot be taken for tissue diagnosis.
- A therapeutic intervention, such as the removal of a polyp (tumor), cannot be performed at the same time.
- During treatment interventions, for example, the abdominal cavity is opened through a large incision instead of through the natural openings of the body.
Disadvantages of open surgery include:
- Longer hospital stay
- Increased risk of complications, including infections
- Longer convalescence (recovery time)
- Comparatively, extensive scarring.
Where to get help
- Your doctor
- The hospital or facility where the procedure was performed.
What you should be aware of Endoscopy is a medical procedure that allows the doctor to inspect and view the inside the body without performing major surgery.
An endoscope is a long, usually flexible, tube with a lens on one end and a video camera on the other. An endoscope is usually inserted through one of the natural openings in the body, such as the mouth, urethra or anus.
Flexible Versus Rigid Endoscopes
Endoscopes are primarily used to view the internal organs of the body. These machines use a tube that is inserted into an incision or natural opening in the body. Endoscopes can be rigid or flexible. Depending on the site being examined, doctors may use rigid or flexible ones.
Flexible endoscopes consist of easy-to-handle, moveable tubes used to view internal organs, while rigid endoscopes are mainly used to view organs longitudinally. A vertical axis. Flexible endoscopes are used in most minor surgeries. This is because they are easy to move, and some parts can be attached to their tip that can cut or scrape tissues for examination.
Rigid tube endoscopes and flexible tube endoscopes have different application methods
Rigid tube endoscopes: mainly penetrates sterile tissues and organs of the human body, or enters the sterile chamber of the human body through a surgical incision, such as laparoscope, thoracoscope, arthroscope, disc mirror, ventriculoscope, etc.
Flexible tube endoscope: It mainly completes the examination, diagnosis and treatment through the natural openings of the human body. Such as gastroscope, colonoscopy, laryngoscope, bronchoscope, etc. They enter the human body mainly through the human digestive tract, respiratory tract and urinary tract.
There are different types of accessories for a flexible endoscope, such as fixed or disposable sheaths, lumens, stylet and biopsy forceps.
Sterilization of flexible endoscopes: advantages & Challenges
STERILIZATION VS. HIGH LEVEL DISINFECTION
To begin a discussion of the benefits of flexible endoscope sterilization versus
High Level Disinfection (HLD), first of all it is vital to understand the key differences between the two.
Most importantly, HLD does not completely eliminate all microbes present on the device being disinfected. In particular, HLD leaves behind a few bacterial spores. In contrast, sterilization processes leave behind no viable microorganisms, including spores.
One of the major challenges in sterilizing endoscopes is the complexity of the equipment. They are highly specialized, made from unique materials and vary greatly in length.
The smallest common flexible endoscope, the rhinolaryngoscope, only has a working length of 300 mm. A colonoscopy, on the other hand, used to visualize and inspect the colon, has a working length of 1680 mm or 1.68 m, which is 5.6 times longer than the rhinolaryngoscope. The nature of flexible endoscopes presents a number of sterilization challenges: The materials used to manufacture flexible endoscopes are not compatible with steam sterilization.
The complexity of the device can lead to bio burden retention. The length of the endoscope or the number of working channels can prevent effective low-temperature sterilization. Ethylene oxide sterilization requires long exposure and aeration times, is hazardous to staff and patients, and may affect the availability of endoscopes for elective and supplemental cases, for high-level disinfection . As discussed above, HLD kills most microbes but can leave spores.
In the US, this is acceptable because GI endoscopes are a Class 2 medical device, meaning they can be reprocessed with HLD as they never come into contact with sterile areas of the body. While this is acceptable, it is not optimal. If leftover spores get into pre-existing wounds or lesions in the gastrointestinal tract, it can cause infection. Previously, GI endoscope infections were thought to occur at a rate of about 1 in 1,000,000.
However, a study by Johns Hopkins found that the rate is actually closer to 1.6 in 1,000. It is clear from this data that finding an appropriate sterilization method that kills all viable microbes, even with Class 2 devices, would benefit both the patient and the facility.
Endoscopes that are normally used with come into contact with sterile areas of the body are Class 3 devices and as such must be sterilized prior to patient use. Flexible endoscopes used for the gastrointestinal and respiratory tract are Class 2 devices as these parts of the body are not normally sterile and as mentioned above, sterilization of Class 2 devices would optimize patient safety during procedures involving these Endoscopes are used.
When it comes to sterilizing flexible endoscopes in general, the common method used to sterilize smaller flexible endoscopes is vaporized hydrogen peroxide (VHP). However, there are certain parameters and criteria that must be met in order for a flexible endoscope to be processed by VHP. For example, the Steris VPRO Max can accommodate single lumen flexible endoscopes with a diameter >1 mm, but a length < 1050mm or a dual lumen finder where one lumen has a diameter <1 mm and a length
of < 990 mm and the other lumen has a diameter > 1 mm and a length of < 850mm This precludes the sterilization of longer GI endoscopes; For example, the Olympus HQ-190F colonoscopy has a working length of 1680 mm. To effectively sterilize these endoscopes, we’ll stick with ethylene oxide.
However, a new technology is emerging that promises to alleviate the length problem: hydrogen peroxide plus ozone. This type of sterilizer pulls the VHP into the chamber and exposes the equipment as expected with a traditional VHP sterilizer. However, a second exposure phase which introduces gaseous ozone into the chamber increases the lethality of the process by an additional 1.8 log, and this additional lethality may sterilize devices such as colonoscopes.6 Therefore, in addition to
VHP, the use of ozone allows flexible class 2 endoscopes are effectively sterilized by a hospital, eliminating all viable microbial life, which in turn makes the endoscope much safer to use on patients than if it had been processed with HLD, whether or not the endoscope comes in contact with sterile tissue .
Of course, with any sterilization method, the flexible endoscope must be clean, leak-proof and completely dry before reprocessing. We have seen the challenges faced in effectively sterilizing the flexible endoscope. Especially with larger gastrointestinal endoscopes, the complexity of the devices makes sterilization difficult, but not impossible. As technology continues to advance, both institutions and patients can only benefit if we apply the same routine sterilization procedures to all flexible endoscopes, regardless of FDA device classification, as are performed with standard surgical instruments.
Whether it is the producing of a flexible or rigid endoscope, Excellent Endoscopy is there for you. We service almost all types of endoscope production and also sell flexible endoscope replacement parts and other accessories.