The ins and outs of scopes: the 6 scopes you need to have this year
Posted on 5 February 2021
Be proactive in 2021 and make it your year of healthy living. Better known as scopes, endoscopies are vital tools in preventing, detecting and treating numerous diseases and injuries.
“An endoscope is a flexible or rigid tube with a light source and camera attached to the end of it,” explains Dr Khalid Coovadia, a gastroenterologist at Mediclinic Panorama. “It has a hand lever attached to the side that allows you to manoeuvre the scope and a channel through which to pass instruments. A scope allows you to visualise the inside of the organ and perform procedures where needed.” Scopes generally only require day admission.
There are three types of scopes:
– surveillance – monitoring disease recurrence
– diagnostic – finding the problem and taking biopsy samples when needed
– interventional – performing medical procedures like removing polyps
While most scopes are only needed when a particular problem arises, others are also effective screening tools. Such is the case with a colonoscopy.
A colonoscopy is done with a long, flexible tube inserted through the rectum, then feeding it through to the other end of the large intestine or colon. Usually conducted by a gastroenterologist, it allows for the examination of the lining of the colon. Bowel preparation is required the day before, cleansing the colon, and thus allowing for an unobstructed view.
Colonoscopies are usually recommended when there is unexplained:
- weight loss
- iron deficiency
- rectal bleeding
- abdominal pain
Dr Coovadia also stresses the importance of having potentially lifesaving screening colonoscopies, something that’s underpromoted. “Colon cancer is one of the most common cancers in the world across developing and developed countries,” he says. “It’s a problem because it’s hidden, unlike skin cancer which is outwardly visible so generally detected and treated early.”
That’s why it’s essential for men and women to have screening colonoscopies starting at the age of 45 years, even in the absence of symptoms. “If everything is normal, these screening colonoscopies are repeated every ten years,” he continues.
Screening colonoscopies are recommended for those who have a family history of hereditary gastrointestinal cancers or polyposis syndrome. Here it is wise to undergo a colonoscopy ten years prior to the age at which one’s parent was when he/she was diagnosed.
The oesophagus, stomach and small intestine are examined during a gastroscopy.
A gastroscopy is indicated when there is:
– unexplained GI (gastrointestinal) bleeding, often in stool or vomit
– difficulty with or painful swallowing, food getting stuck
– unexplained weight loss
– epigastric burning pain – pain right below one’s ribs in the upper abdomen
– unexplained gastric outlet obstructions
– unexplained vomiting
Urinary tract scopes
Dr Hans Rabe, a urologist at Mediclinic Panorama, explains that cystoscopies allow doctors to look into the bladder with a telescope. “There are two types of telescopes or cystoscopes, flexible and rigid,” he explains. “A flexible telescope is purely used for surveillance and the cystoscopy is done under a local anaesthetic. With a rigid telescope, you can also do things like a biopsy.” This is done under general or spinal anaesthetic.
Cystoscopies are advised when there is:
– blood in the urine
– difficulty in passing urine
– urine runs out on its own
– recurrent urinary tract infections
– a follow-up needed for certain bladder conditions
Recovering bladder cancer patients have scopes after three months, then after six months and then nine months later. Thereafter, they’re done annually.
This is a scope enabling doctors to look up the ureter right into the kidney. It is performed to remove kidney stones or stones found in the ureter.
Nephroscopes are used to look inside the kidney via a puncture through the skin on the back. In this way, large kidney stones can be drilled out by ultrasonic lithotripsy. This efficient procedure allows for a controlled destruction of the stone and a quick removal of the resulting fragments.
“Here a very thin flexible ureterorenoscope can be used to laser stones in the kidney or ureter from the inside,” explains Dr Rabe.
The bare bones
“An arthroscope is a remote device with a camera on it, that enables one to look inside a joint,” explains Dr Phillip Webster, an orthopaedic surgeon at Mediclinic Sandton. Common joints for which arthroscopic procedures are indicated include the shoulders and knees, but it is possible to perform an arthroscopy of any joint including hips, ankles, elbows and wrists.
While it can be used for diagnostic purposes, it’s more frequently used with other instruments for therapeutic interventions. “It allows you to do minimally invasive surgery while using the camera and various devices to repair damaged tissues in the joints,” explains Dr Webster.
“Arthroscopy only requires little cuts on the skin, you bypass tissues when going towards the joints, and recovery is that much better because you don’t have to reattach muscles and do an open operation. By turning the lens 360 degrees, you can often see much more within the joint than you can with open surgery, allowing you to visually assess damaged structures within the joints and accurately repair these structures.”