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Information

Endoscopy is the general term given to all examination and inspection of body organs or cavities using an endoscope. An endoscope is a fiberoptic instrument used for direct visual examination of certain internal body structures by means of a lighted lens system attached to either a rigid or flexible tube. A fiberoptic instrument transmits signals from the tip of the scope via glass or plastic threads to a monitor. Light travels through an optic fiber by means of multiple reflections. A fiberoptic instrument is composed of fiber bundle systems that redirect and transmit light around twists and bends in cavities and hollow organs of the body. An image fiber and a light fiber allow visualization at the distal tip of the scope. Separate ports allow instillation of drugs, lavage, suction, and insertion of a laser, brushes, forceps, or other instruments used for excision, sampling, or other diagnostic and therapeutic procedures. The flexible scope can be inserted into orifices or other areas of the body not easily accessed or directly visualized by rigid scopes or other means.

Procedures are done for health screening, diagnosis of pathologic conditions, or therapy, such as removal of tissue (polyps) or foreign objects. Sedatives or analgesia (to achieve a state of conscious sedation) or local or general anesthetics may be used. The use of video documentation and endoscopic sonography (diagnostic imaging for visualizing subcutaneous body structures) also aids in cancer diagnosis, staging of cancer, and determining operability. Biopsy tissue is submitted to the laboratory for histologic examination (see Chapter 11).

Procedural Alert

  1. Observe standard precautions and latex precautions for all endoscopic procedures.

  2. Endoscopically related bacteremia infections may result from tissue manipulations, bloodstream invasion by pathogens, or a contaminated endoscope, usually due to improper cleansing and disinfection. It is important that strict infection control guidelines be followed by persons who clean and disinfect the endoscopes. Hospitals and clinics should follow the infection control policies for their institution, which should include documentation of all endoscopic procedures, including name of patient, type of procedure, date and time of procedure, and serial number of the endoscope used in each procedure. A log documenting the time, date, and serial number of each endoscope cleaned and disinfected should also be maintained. These records allow for tracing an infection back to a specific instrument. Any infections suspected to have been caused by a contaminated instrument should be reported immediately to the appropriate infection control and risk management departments for investigation.

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