Endoscopy: A journey into the inner world of man

Curiosity in a person's blood. And as interest in what is going on inside our body has always been genuine and unquenchable. Look into the inner world of man and see him all the details possible endoscopy. The term comes from two Greek roots: Endon— Inside andskopeo— I look, "vnutriglyadenie," as one would say Slavophils XIX century. Endoscopy— This is an instrumental method for studying the internal organs. This study is conducted by means of special devices — endoscopes.

Historical background

If you think you have endoscopy — this technological invention of the XX century, you are mistaken. In 2006 it will be exactly 200 years since the invention of the first endoscope. That's right, this method is a century older than X-ray diagnostics. True, designed by Philip Bozzini (Philip Bozzini) instrument for the study of the uterus and the rectum has never been tested in practice. The medical community has criticized the Vienna invention Bozzini and punished for the "strangeness". The inverse image of the endoscope called Lichtleiter («conductor of light, light guide" — it.) And use a candle as a light source.

On the strange device Bozzini lost almost 50 years and only in 1853 by a French surgeon Jean Desormo Anthony (Antoine Jean Desormeaux) Lichtleiter perfected for use in urological practice. He rigged endoscope alcohol lamp and first used in the study of bladder patients. It is for these achievements Desormo many consider "the father of endoscopy." It should be noted that his unit did not differ perfection — burns sensitive mucosa were not at all uncommon.

With the development of science evolved and endoscopes. The discovery of electricity allowed Maximilian Nitze (Maximilian Nitze) in 1876 once again modify Lichtleiter, using as a light source lamp Edison. In XX century endoscopes first gained partial flexibility of the system and short-throw lens that allows viewing up to 7/8 of the gastric mucosa. Then they got fiber optics and flexible snake, and at the end of the XX century are electronic, joining together with all of humanity in the digital era.

Methods and Devices

Thus, endoscopy — a general name diagnostic methods and depending on body which investigated, say, or a gastroscopy (endoscopy of the stomach), or colonoscopy (endoscopy of the colon), or bronchoscopy (bronchial endoscopy) or laparoscopy (abdominal endoscopy) or thoracoscopy (endoscopic thoracic cavity), or cystoscopy ( Endoscopy of the bladder) or the combined studies, for example, esophagogastroduodenoscopy, better known as EFGDS or "swallowing gut" (if it is absolutely in a national way). When EFGDS investigated whole digestive tract from the esophagus to the duodenum, and this is one of the most common diagnostic procedures. That's about it first of all recalls the majority of patients, when they hear the word "endoscopy. "

Current endoscopes are long flexible plastic or rigid metal tube with a lens at one end. First applied to the study gastrointestinal tract and bronchi, the second — to study the thoracic and abdominal cavities, and in some other cases. In the endoscope can combine two channels — one optical, providing medical review of the internal organs (through the use of fiber optics resulting image is not distorted) and the second — for a variety of specialized tools that allow for further manipulation, which will be discussed below.

Usually endoscopic research does not require special preparation of the patient difficult. Most often, the patient is required to come on an empty stomach (10-12 hour break in the meal). Those who are assigned to colonoscopy will have to do — they need to advance clean your intestines. Usually all training schemes in advance dispensed to patients in the form of a printed memo, or if it is in-patients and their controls and conducts training medical personnel.

Capabilities

Endoscopy allows you to examine in detail the mucosa and lumen organs and cavities. With the development of endoscopy has been made simple diagnosis of common diseases, such as peptic ulcer of the stomach and duodenum and colon polyps. Previously, ulcers or a polyp can be detected only during the x-ray, i.e. at a late stage of the disease. Endoscopy allowed to "catch" these insidious disease early, when it is possible and successful low-impact treatment. Operates one of the basic principles of medicine — Bene diagnoscitur — Bene curatur ("Good diagnosed — well treated," Lat.).

Modern endoscopy allows to extend the diagnostic capabilities. So, with the help of special "tweezers", which entered into a separate channel of the endoscope under direct vision may take a piece of mucosa for further study (biopsy). Sets of special tools that can be incorporated in the endoscope allow other, more complex manipulations. For example, to remove a foreign body or a polyp is found, an injection of the drug directly to the affected area to stop bleeding from the ulcer (in some cases it will avoid a lot of surgery with dissection of the anterior abdominal wall).

Rapidly evolving whole direction — endosurgery, that is to guide surgery using endoscopic techniques. This is a minimally invasive technique that significantly reduces post-operative period and contribute to the speedy recovery of patients. For example, performed laparoscopic gallbladder removal or performed gynecological surgery.

Novelty

Science moves forward and invent new methods and instruments. Here came to the turn of the endoscope. Italian scientists from the Graduate School of St. Anne (Scuola Superiore Sant'Anna) invented in Pisa endoscope, which in the survey is "creep" in the patient's intestine itself. The basis of the device are laid writhing movements of marine worms — Nereids.

The purpose of the new development — to minimize the discomfort of the unpleasant procedure for the patient. The introduction of the new endoscope is much easier, although it takes more time. The device is a tube, the length of which extends a flexible axis and laterally nominated protrusions resembling worms bristles (another name nereids — polychaete worms). Scientists have created a test model of the endoscope and now consult with biologists to follow the model acted as possible like worms. Also in their plans to make the "worm" move faster with the motor of. Test model of "creeping" into the intestine within 30 minutes, whereas the administration of a conventional endoscope in just 10 minutes.

According to team leader Paolo Dario (Paolo Dario), a new technique to study intestinal borrowed from nature and can turn this process of suffering for the patient into something pleasant. About the "pleasant" scientist, I think, exaggerated, but less painful study may well be. On the other hand, it is difficult to predict a patient's response, which begins in the rectum something (Or someone?) Crawls.

Complications

Any invasion of the human body, including diagnostic research, poses a potential danger. This also applies to endoscopy. Most likely, but fortunately rare complication — this body wall perforation and bleeding that occurs from either the mucosal injury endoscope, either at the time of manipulation (biopsy, removal of a polyp). Both of these conditions require immediate surgical intervention.

Another complication — is the possibility of infection during the procedure. The fact is that the endoscopic technique to subject a thorough cleaning and disinfection is not easy even if you follow the instructions exactly. According to the official information of the American Society for Gastrointestinal Endoscopy, the probability of infection is less than one case per 1.8 million research. However, according to David Luiz (David Lewis), a microbiologist at the University of Georgia, is a real risk of infection when endoscopy is higher.

According to his calculations, it appears that the possibility of infection is approximately every hundredth study. The real figure is infected somewhere the middle. The problem is that assess the actual level of infection is very difficult, since most of the patients and their doctors do not tend to associate arisen intestinal infection with the procedure.

The research that was conducted in 1995 at 80 hospitals showed that in 38 cases after purification by conventional methods on the apparatus they could detect visible traces of impurities. Not all of them, of course, have an infectious component, but dirty tools facilitate the transmission of germs.

Invented new disinfectant, developed new regulations and methods of processing endoscopes — all this greatly reduces the risk of infection during the procedure.

Despite the existing potential for endoscopy, all doctors agree that it is better to pass. The risk of developing complications of the modern development of the endoscopic technique is very small, but the risk of delayed diagnosis of pathological processes, such asgastrointestinal tract — is very real.

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