Surgery has, and continues, to evolve at a remarkable pace. Medical science has pushed the boundaries of possibility to move surgery from its early days, of what today may be looked upon as positively barbaric, to what it is today. Today, previously life-threatening procedures, are now routine and minimally invasive.
In 1843 surgeons took a giant leap in surgery with the introduction of ether as an anesthetic, from this moment on anesthesia became an integral and technical part of surgical procedures. In 1867 Joseph Lister published Antiseptic Principle in the Practice of Surgery, as a result of adopting Lister’s principles, surgical mortality rates fell dramatically. 1940 saw the first metal hip replacement, and in 1950 the first successful kidney transplant was undertaken.
South African surgeon, Christian Barnard undertook the first heart transplant in 1967, and in 1975 the first surgical procedure was undertaken using laparoscopy. From here on, surgery would be dramatically changed by its use of cameras. This has enabled surgeons to execute deep and intricate surgical procedures using less invasive methods, much to the benefit of the patient.
Endoscopy is the overall encompassing medical term to describe minimalistic invasive surgery via the use of cameras. From the Greek, “Endo” means “Within” and scope is to “Look out”, and so, endoscopy is a very apt term to describe this surgical technique. Today, endoscopic technology has revolutionized surgery for both surgeons and patients.
The less invasive nature of the main endoscopy procedures is a big plus for the patient. Many procedures can be carried out on an outpatient basis, sometimes using a local anesthetic. To facilitate the use of an endoscope, the doctor may utilize the body’s natural orifices or via a small incision in the body. This incision may be well away from the area that is to be investigated or treated.
An endoscopic procedure can aid doctors in investigating a patient’s symptoms when other diagnostic techniques have been inconclusive. It allows doctors to see directly into the patient’s body and the source of a medical problem.
The use of an endoscope allows doctors to confirm a preliminary diagnosis that may have been made by more conventional methods, and where necessary to conduct a biopsy. This is particularly advantageous in the diagnosis of diseases such as cancer. The endoscope can also be utilized with other diagnostic tools, such as an ultrasound scan. Some organs can be difficult to image, such as the pancreas, an ultrasound scan can aid doctors by giving more detailed information which helps to achieve an accurate diagnosis.
Endoscopic Treatment and Surgery
Endoscopic treatments are now many and varied, encompassing routine procedures to life changing surgery. From a straightforward appendectomy to delicate heart surgery involving skillful intrathoracic maneuvers. The removal of the gallbladder and small tumors, hysterectomies and prostatectomies are just a few of the many procedures that have now become far less traumatic with the minimally invasive introduction of endoscopy.
Risks of Endoscopic Procedures
Although endoscopic procedures are relatively low risk, as with any medical treatment some level of risk is inevitable.
Some endoscopic procedures will require sedation, and as with more conventual surgery, over sedation of a patient is not unheard of. A small percentage of patients may have an adverse reaction to anesthesia, and so, post-surgery patients are monitored for signs of any complications. Nausea, vomiting and dizziness are the most common, along with light sensitivity and hypertension.
The use of surgical instruments and the opening of the body will give risk of the area being investigated or treated becoming infected. Although not common and usually minor, in the instances of infection, a course of antibiotics will be prescribed to cure the problem.
With instruments entering the body there is a risk that, on occasions, there may be a perforation, tear or cut in tissues which result in bleeding. This is possible, but any bleeding is unlikely to be extensive and can easily be stemmed by endoscopic cauterization.
Side effects of an Endoscopy
Side effects to an endoscopic procedure are not uncommon and these side effects can manifest themselves in many different ways. As previously stated, most side effects are likely to be related to anesthesia and sedation.
Other side effects are likely to vary depending on the nature of the procedure that has been carried out, and the area of the body that has be subject to the procedure.
Stomach cramps and bloating are common after gastro endoscopy treatments, as is a sore throat and a difficulty in swallowing. Pain at the site of the procedure can be expected, although this is rarely more than temporary, and can be relieved with pain killers as advised by a doctor.
Post Endoscopy Concerns
It is possible that some patients may experience post-treatment symptoms that are of more concern than the normal side effects. Chest pains and a shortness of breath should not be ignored, persistent and sever abdominal pains, vomiting blood and dark colored stools are also of concern. These, and any other ongoing or incapacitating symptoms, should be reported to a doctor for appraisal and diagnosis and, if necessary, further treatment.
Recovery from Endoscopic Procedures
Patients that have already been admitted to hospital, and undergo an endoscopic procedure, will be monitored by the medical staff to ensure their wellbeing post treatment. With many people being treated as out patients, there are a few things to be aware of. Immediately after treatment the patient will be cared for until any atheistic or sedation has worn off, usually within a couple of hours.
A patient should not return to any form of work or operate any machinery immediately after treatment, or attempt to drive. It is advisable to be accompanied home by a friend or family member who can stay with you for the remainder of the day, or until you are fully recovered. The patient should rest and take any course of medication that has been prescribed to them.
Endoscopic Treatment and the Future
Endoscopic procedures have advanced tremendously over the last 10 years and the evolution is sure to continue. Further miniaturization of equipment is inevitable which will further reduce the invasive nature of surgery and patient trauma.
As technology and practical skills advance, the range of endoscopic procedures will become ever greater. Invasive treatments will become less so, inpatient numbers will fall, procedure costs will reduce and patient health and wellbeing will benefit.
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