Diagnostics
Endoscopic surgery
What is endoscopic surgery?
Endoscopic surgery, also known as minimally invasive or keyhole surgery, is a surgical procedure that uses specialized instruments and a small camera (endoscope) to diagnose and treat various conditions inside the body.
Endoscopic surgery is a modern surgical technique that allows surgeons to perform procedures without making large incisions. Instead, they use a slender, flexible tube called an endoscope that contains a light source and a camera at its tip. The endoscope is inserted through small incisions or natural body openings, such as the mouth or nose, to visualize internal structures.
Who performs endoscopic surgery?
Endoscopic surgery is performed by various specialists who are trained in minimally invasive surgical techniques. Some of the common specialties and procedures where endoscopic surgery is utilized include:
- Gastroenterologists: Gastroenterologists use endoscopy to examine and treat conditions of the digestive tract. Common procedures include esophagogastroduodenoscopy (EGD) to examine the esophagus, stomach, and duodenum, and colonoscopy to assess the colon and rectum. They also perform endoscopic retrograde cholangiopancreatography (ERCP) for conditions of the bile ducts and pancreas.
- Gynecologists: Gynecologists use hysteroscopy and laparoscopy for minimally invasive procedures within the female reproductive system. These procedures can include the removal of uterine fibroids, diagnosis and treatment of endometriosis, and laparoscopic-assisted hysterectomy.
- Orthopedic Surgeons: Orthopedic surgeons may use arthroscopy to diagnose and treat joint conditions, such as knee or shoulder problems. This involves inserting an arthroscope into the joint to visualize and address issues like torn ligaments or damaged cartilage.
- Urologists: Urologists perform endoscopic procedures for conditions involving the urinary tract, such as transurethral resection of the prostate (TURP) for an enlarged prostate or ureteroscopy for kidney stone removal.
- ENT Surgeons: Ear, nose, and throat (ENT) surgeons use endoscopy to examine and treat conditions of the ear, nose, throat, and related structures. Procedures may include endoscopic sinus surgery, laryngoscopy, and otoscopy.
- Thoracic Surgeons: Thoracoscopy is employed for investigating and treating conditions within the chest, such as pleural effusions, lung nodules, and biopsies of suspicious chest masses.
- General Surgeons: General surgeons trained to perform a wide range of surgical procedures and have expertise in various minimally invasive techniques, including laparoscopy. They often handle procedures within the abdominal and pelvic regions. Some common procedures in the abdominal and pelvic area that general surgeons may perform using endoscopic techniques include laparoscopic cholecystectomy, appendectomy, hernia repair, colectomy, and gastric bypass.
The choice of surgeon depends on the specific medical condition and the level of expertise needed for the procedure. Patients should consult with their consulting doctor or surgeon to determine the most appropriate specialist for their particular situation.
What is the procedure for performing endoscopic surgery?
Before surgery
- The patient undergoes a preoperative evaluation, including a medical history review and diagnostic tests to assess their suitability for the procedure.
- Preoperative instructions are provided to the patient, which may include fasting before surgery, discontinuing certain medications, and showering with a special antiseptic soap.
- Consent for the surgery is obtained from the patient or their family members after explaining the procedure, potential risks, benefits, and alternatives.
During surgery
- Before the surgery begins, the patient is typically administered anesthesia to ensure they are comfortable and pain-free during the procedure. The type of anesthesia may vary depending on the specific procedure and the patient’s condition.
- A small incision is made in the skin, often no more than a few millimeters to a few centimeters in size, through which the endoscope and surgical instruments are introduced. The location of the incision depends on the specific procedure.
- The endoscope, which contains a light source and a camera, is inserted through the incision or natural body opening. The camera allows the surgical team to view the surgical area in real time on a monitor.
- The surgeon uses the endoscope to visualize and access the surgical area. Specialized instruments are introduced through additional incisions, if necessary.
- The procedure is carried out with precision under the guidance of the camera’s images on the monitor.
- The surgeon may perform tasks such as tissue removal, suturing, or other surgical manipulations, depending on the specific procedure.
- After completing the surgical tasks, the surgical instruments and endoscope are removed, and the incisions are either sutured or closed with surgical staples or adhesive strips.
The patient is moved to a recovery area where they are monitored until they wake up from anesthesia.
After surgery
- The patient is observed in the recovery area to ensure they are stable and comfortable.
- Once the patient has sufficiently recovered from anesthesia and is deemed fit for discharge, they are provided with postoperative care instructions.
- The patient may be discharged on the same day for some minor procedures, while more complex surgeries may require a longer hospital stay.
While endoscopic surgery is generally considered safe, like any other procedure, it carries some risks, including infection, bleeding, and persistent pain in the endoscopy area
The risks associated with each type of endoscopic procedure vary depending on the specific location of the procedure and individual patient factors.
If the patient experiences any of the following symptoms, it is essential to contact the doctor immediately:
- Fever
- Vomiting
- Chest pain
- Abnormal stool (e.g., bloody or black stools)
- Shortness of breath
- Severe abdominal pain or any other unusual symptoms
What are the advantages of endoscopic surgery?
- Minimal scarring: Endoscopic surgery involves small incisions, resulting in less noticeable scars than traditional open surgery.
- Faster recovery: The smaller incisions reduce tissue damage, resulting in quicker patient recovery.
- Less pain: Patients experience less post-operative pain and discomfort with fewer and smaller incisions.
- Reduced risk of complications: Endoscopic procedures generally carry a lower risk of infection and other complications than open surgery.
- Shorter hospital stay: In many cases, endoscopic surgery allows patients to go home on the same day or within a short period, minimizing hospital stays.
References
Endoscopy. Available from: https://medlineplus.gov/endoscopy.html
- Endoscopy: What to know. Available from: https://www.medicalnewstoday.com/articles/153737
- 3. Available from: https://www.medicalnewstoday.com/articles/153737
- 4. Types of endoscopy. Available from: https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/types-endoscopy
