ENDOSCOPY

medical examination of the interior of the body, usually through a natural body opening, by the insertion of a lighted optical shaft or open tube. It is customarily performed with local anesthesia. Instruments used include the esophagoscope, a rigid pipe for examination of the esophagus; the bronchoscope, a similar pipe for examination of the bronchial tubes; and the gastroscope, a flexible lighted shaft for examination of the stomach. These are passed through the mouth into the respective organs. The examinations are usually performed in a hospital, but the patient ordinarily is dismissed immediately thereafter. The open-tube proctosigmoidoscope is passed through the anal orifice without anesthesia for examination of the rectum and lower colon and is a common office procedure. The cystoscope, a lighted rod, is passed through the urethra with local or general anesthesia for examination of the bladder. Three endoscopic procedures require incisions for the introduction of the lighted shaft where natural openings do not exist. The thoracoscope permits examination (for suspected adhesions in patients with tuberculosis) of the chest cavity and surface of the lungs through a small incision between the ribs. The peritoneoscope allows examination of the abdominal cavity and lower surface of the liver and gallbladder through a small incision in the abdominal wall. The culdoscope permits examination of the female pelvic organs through a small vaginal incision. The fibre-optic endoscope is a pliable, highly maneuverable instrument that allows access to channels in the digestive tract that were previously inaccessible to the older, semirigid instruments. Composed of multiple hairlike glass rods bundled together, this instrument can be more easily bent and twisted, and the intense light enables the endoscopist to see around corners as well as forward and backward. Accessories can be added that make it possible to obtain cell and tissue samples, excise polyps and small tumours, and remove foreign objects.