Endoscopy Procedures
Endoscopy refers to the visualization of internal organs using an apparatus, that usually pass through a natural bodily orifice like the mouth or anus. This “camera system” can usually be steered to point in different directions, and so organs which are otherwise unreachable, can be evaluated for disease. Working channels allow the passage of micro-instruments, which can not only be used to biopsy suspicious lesions, but also treat diseases such as gastrointestinal bleeding from a vessel, removal of polyps or placement of stents or other prosthesis.
The most common endoscopic procedures include gastroscopy (which visualizes the gastrointestinal tract from the mouth to the start of the small bowel), and colonoscopy (from the anus to end of the small bowel).
In addition to the abovementioned procedures, we also offer endoscopic retrograde cholangiopancreatography (ERCP), which is a procedure done for evaluation and treatment of diseases of the ducts of the liver, including obstruction due to cancer or even gallstones that pass into the ducts via the gallbladder.
Gastroscopy
As described above, gastroscopy is aimed at looking for diseases of the esophagus, stomach or duodenum (first part of the small bowel). Common diagnoses include peptic ulcer disease, reflux of gastric fluid into the esophagus, herniation of the stomach into the chest cavity, or even gastric cancer. These usually present as upper abdominal pain or reflux, bloatedness, or sometimes vomiting of blood.
Gastroscopy is usually a short procedure taking about 20 minutes to complete, and is most commonly done as an outpatient. It is very safe and is usually well tolerated, especially when done under conscious sedation. Adverse events are rare.
A helpful Q&A guide on Gastroscopy can be found below.
Colonoscopy
Colonoscopy is concerned with detection and treatment of diseases of the lower gastrointestinal tract, extending from the terminal ileum (last part of the small bowel), through the colon and rectum all the way to the anus. It is often done to evaluate for the presence of polyps, which are often forerunners of cancer of the colon. The main aim here is early detection of lesions which are not yet malignant, thus enabling preventative treatment. The procedure usually takes about 45 mins and is most commonly done under conscious sedation.
The most common adverse effect is related to the insufflation of air, as one can experience a feeling of bloatedness or abdominal distention and/or discomfort during, or immediately after the procedure. This is usually mild and resolves spontaneously. Other risks are the potential to cause injury to the bowel itself, and rarely even perforation. This is however rare and more frequently seen during therapeutic procedures such as polypectomy.
You can continue reading about the procedure below.
Endoscopic retrograde cholangiopancreatography (ERCP)
ERCP is a complex procedure that is done to evaluate diseases of the bile ducts and nearby organs. It is done using an endoscope passed through the mouth, whereafter instruments are passed into the bile ducts, which is then visualized using x-ray localization. After cannulation of the ducts, different devices can then be utilized to remove obstructing gallstones or other objects within the ductal system, or stents can be used to relieve obstruction due to cancer. In the case of malignancy (cancer), ERCP can sometimes be used to obtain tissue in the form if brushing the inside of the bile duct, or even taking a biopsy of offending lesions if possible. This procedure is done under general anaesthetic, and one can expect to overnight in hospital (although it can sometimes be done as an outpatient procedure).
Although very safe, possible adverse events are related to bleeding (very rare), the development of pancreatitis after the procedure (also rare, and usually mild, although sometimes more severe), or sepsis due to bile duct infection (very rare).
More patient information can be found below.