Endoscopic procedures
Endoscopy is the examination of the digestive tract from the inside, using a thin flexible instrument with a camera at its tip. The pages below explain how each procedure is performed.
The instrument
- Control head
- Angulation knobs (up–down, left–right)
- Suction and air/water valves
- Biopsy port — instruments pass in here
- Cord and connector to the light source
- Insertion tube, marked in centimetres
- Bending section
The tip, magnified
- Camera lens
- Light guides (two)
- Working channel
- Air/water nozzle that rinses the lens
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Gastroscopy
Gastroscopy is the procedure of examining the upper digestive tract with a long, tube-shaped, flexible instrument that has its own light source and a camera at its tip.
- Duration
- 5–15 minutes
- Sedation
- Optional
- Preparation
- Usually 6–8 hours without food
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Colonoscopy and Preparing for It
Colonoscopy is the examination of the inner surface of the large bowel with a thin, flexible instrument carrying a camera, allowing biopsies and the removal of polyps where these are needed.
- Duration
- 20–30 minutes
- Sedation
- Usually given
- Preparation
- Bowel cleansing
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Polypectomy (Removing a Polyp)
Polypectomy is the removal of polyps in the stomach or bowel during endoscopy or colonoscopy; no incision is made, and removing suitable polyps can prevent bowel cancer.
- Duration
- 5–30 minutes added to the colonoscopy
- Sedation
- Usually given
- Preparation
- Bowel cleansing
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Oesophageal Manometry (Measuring Pressure in the Gullet)
Oesophageal manometry is a test that measures how the muscles of the gullet and the valve at the entrance to the stomach are working. It is used above all to look for the cause of difficulty in swallowing.
- Duration
- 20–30 minutes
- Sedation
- Not given
- Preparation
- At least 6 hours without food
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Endoscopic Ultrasound (EUS)
EUS combines endoscopy and ultrasound in one instrument; it images the pancreas, the bile ducts and the wall of the digestive tract from very close by, and allows a tissue sample to be taken during the same procedure.
- Duration
- 15–60 minutes
- Sedation
- Sedation is given
- Preparation
- 6–8 hours without food
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ERCP (Endoscopic Retrograde Cholangiopancreatography)
Imaging the bile and pancreatic ducts with an endoscope, and treating what is found in the same session.
- Duration
- 30–60 minutes
- Sedation
- Sedation or general anaesthesia
- Preparation
- 6–8 hours without food
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Endoscopic Mucosal Resection (EMR)
Removing polyps and early lesions from the surface of the digestive tract by lifting them with injected fluid and cutting them away with a wire snare.
- Duration
- 20–45 minutes
- Sedation
- Sedation is given
- Preparation
- Nothing by mouth; bowel cleansing for the large bowel
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Endoscopic Submucosal Dissection (ESD)
Removing early cancers and large lesions in one piece with an endoscope, by dissecting them free from beneath the lining with special knives.
- Duration
- 1–3 hours
- Sedation
- General anaesthesia or deep sedation
- Preparation
- Nothing by mouth; blood thinners stopped
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Cystogastrostomy (EUS-Guided Cyst Drainage)
Opening a route with an endoscope between a cyst on the pancreas and the stomach, so that the cyst drains into the stomach.
- Duration
- 30–60 minutes
- Sedation
- General anaesthesia or deep sedation
- Preparation
- Nothing by mouth; clotting tests
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Hepaticogastrostomy (EUS-Guided Biliary Drainage)
Opening a route with an endoscope between a bile duct inside the liver and the stomach, where ERCP cannot be done or has failed.
- Duration
- 45–90 minutes
- Sedation
- General anaesthesia
- Preparation
- Nothing by mouth; clotting tests
-
Gastrojejunostomy (EUS-Guided Stomach-to-Bowel Bypass)
Creating a stented passage with an endoscope between the stomach and the small bowel, where the outlet of the stomach is blocked.
- Duration
- 45–90 minutes
- Sedation
- General anaesthesia
- Preparation
- Nothing by mouth; the stomach emptied