Endoscopic procedures

Endoscopy is the umbrella term for a group of medical procedures that use an endoscope—a thin, tubular scope with a lens and light—to examine the inside of your body. This way, your doctor can see tissues inside the body closely to look for abnormal changes, blockages, growths or other issues that may be causing symptoms.

In some cases, the scope also has a tool for removal of tissue to be examined for disease.

The different types of endoscopy procedures

There are several types of endoscopy, each tailored to a specific part of the body, such as the lungs, colon, or vocal cords. Learn more about some of the more common procedures you might undergo as part of cancer screening or diagnosis:

Bronchoscopy

Bronchoscopy is a procedure performed to examine the inside of the lungs. It’s performed with a type of endoscope called a bronchoscope. The scope is inserted through the nose or mouth, goes down the throat to the trachea (windpipe) and into the bronchi and bronchioles (airways) of the lungs.

Bronchoscopy may be performed for the following reasons:

• To understand why you’re having issues with your lungs
• If your doctor suspects that a certain area of tissue may be cancerous
• To view the lymph nodes near your lungs
• To treat certain lung issues

The procedure is typically safe, but there is a small risk of the following complications:

• Bleeding in the airways
• Pneumothorax (collapse of part of the lung)
• Pneumonia (lung infection)

Colonoscopy

This procedure is performed to examine the inside of the colon and rectum. It’s performed with a type of endoscope called a colonoscope. The scope is inserted through the anus and into the rectum and colon. Additional instruments can be moved through the scope in order to take a biopsy or remove areas of tissue that look suspicious, such as colorectal polyps.

Colonoscopy may be performed for the following reasons:

• To look for polyps or cancer in the colon or rectum
• If you’re experiencing issues with your colon or rectum
• To treat certain colorectal issues

The procedure is typically safe, but there is a small risk of the following complications:

• Blood may appear in your stool for a couple of days after a biopsy is taken or polyp removed during colonoscopy. Severe bleeding is uncommon; however, in rare cases bleeding may need to be treated and sometimes is life-threatening.
• Punctures in the wall of the colon and rectum are rare, but when they occur, they can be life-threatening, and therefore may need surgery.
• Reaction to anesthesia

Cystoscopy

This procedure is performed to examine the inside of the bladder and urethra. It’s performed with a type of endoscope called a cystoscope. The scope is inserted via the urethra, which carries urine outside the body.

Cystoscopy may be performed:

• If you’re having problems with your bladder
• To check an area that your doctor suspects may be cancer
• If you have a bladder problem that needs to be treated

Cystoscopy is typically safe, but there’s a small risk of the following complications:

• Bladder infection
• Reaction to anesthesia
• Rupture in the bladder wall

Laparoscopy

Laparoscopy, also known as keyhole surgery, is performed to examine the inside of the abdomen and pelvis. It’s performed with a type of endoscope called a laparoscope. The scope is inserted via a small incision made in the abdominal wall near the belly button. Additional incisions may be made in other areas of the belly to insert additional instruments.

Laparoscopy may be performed:

• If there is an issue with your abdomen or pelvis
• To examine an area that your doctor suspects may be cancer
• To treat a small area of cancer

Potential risks of laparoscopy include:

• Bleeding
• The need for a laparotomy, a procedure in which the abdomen is opened via a larger incision because it couldn’t be performed with the smaller incisions used in laparoscopy
• Pneumonia (lung infection)
• Infection in the incisions
• Injury to adjacent organs, namely the bladder and bowel

Laryngoscopy

This procedure is performed to examine the vocal cords, other structures of the larynx (voice box), and adjacent structures such as the back of the throat.

Laryngoscopy may be performed:

• If you’re experiencing throat problems or problems with your voice
• To take biopsies of suspicious-looking areas
• To treat certain issues with the voice box

The procedure is typically safe, but potential risks include:

• Bleeding in your throat
• Reaction to anesthesia
• Infection
• Hoarseness

Mediastinoscopy

This procedure is performed to examine the inside of the mediastinum, located between your lungs and the back of your breastbone. It’s performed with a type of endoscope called a mediastinoscope. The scope is inserted via a small incision right above the breastbone and slowly moved into the mediastinum.

Mediastinoscopy may be performed if your doctor feels that the lymph nodes or the area between the lungs needs to be further examined.

Potential risks of mediastinoscopy include:

• Bleeding
• Pneumothorax (collapse of part of the lung)
• Pneumonia (lung infection)
• Hoarseness
• Infection in the incisions

Thoracoscopy

This procedure is performed to examine the area inside the chest and outside the lungs. It is performed with a type of endoscope called a thoracoscope. The scope is inserted through a small incision made near the lower section of the shoulder blade. In some cases, thoracoscopy is performed as part of a video-assisted thoracic surgery (VATS).

Thoracoscopy may be performed:

• To assess why you are experiencing lung problems
• If there is an area of the chest that your doctor considers suspicious
• To treat small lung cancers
• If there is fluid near the lungs

Potential risks of thoracoscopy include:

• Bleeding
• The need to perform a thoracotomy, during which the chest cavity is opened with a larger incision when the procedure could not be performed with a smaller incision
• Pneumonia (lung infection)
• Pneumothorax (collapse of part of the lung)
• Infection in the incisions

Upper endoscopy

Also referred to as esophagogastroduodenoscopy, or EGD, upper endoscopy is performed to examine the inner lining of the upper digestive tract (upper part of the small intestine), which includes the stomach, esophagus and duodenum.

Upper endoscopy may be performed:

• If you’re experiencing issues with the upper digestive tract
• If your doctor suspects that a certain area might be cancerous
• To treat a digestive system issue

The procedure is typically safe, but potential risks include:

• Bleeding at a site where tissue samples were taken
• Perforation, or a puncture in the digestive tract lining
• Reaction to anesthesia
• Bleeding

In many cases, bleeding is minor and resolves on its own. Cases involving more serious bleeding may require treatment, including surgery.

Preparing for endoscopy

Endoscopy is usually an outpatient procedure, meaning most people don’t need to stay overnight in a hospital. There are some key ways to prepare for the procedure:

• Keep your doctor informed on what medications you’re taking. Make sure to tell your care team about any medications, vitamins, supplements and/or herbs you take, as well as any allergies to medication. Your doctor may advise you to stop taking certain medications, including anything that thins the blood, like aspirin, prior to undergoing an endoscopy procedure.
• Find out about the eating and drinking protocol before your procedure. Your doctor may ask you to avoid eating or drinking anything for at least a few hours leading up to the procedure.
• Follow all prep instructions from your doctor closely.

After your endoscopy procedure, your care team will monitor you to ensure that you aren’t developing any complications and provide written post-op instructions.

Endoscopy results

If your endoscopy procedure involves biopsies, it most likely will take a few days to receive the results, although some types of biopsies may take longer.