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| Video Colonoscopy |
Rectal Cancer |
Endosonography |
Stalked Polyp, familiar polyposis of the colon. |
Polyp in the appendix hole. |
Crohn`s disease. |
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Video-colonoscopy makes high definition video images of
the whole colon possible. The exam enables the complete visualization
of the large intestine from the anus to the cecum, covering a distance
of approximately 1.5 meters.
This technology has been greatly improved with the development of Computerized
Video-Colonoscopy systems which makes high resolution visualization and
imaging of the colon. These images may be captured and stored on VHS,
Betacam or U-Matic Tape or on Optical Disk or DVD.
For the procedure, you will lie on your left side on the examining table.
.The scope transmits an image of the inside of the colon, so the Gastroenterologist
can carefully examine the lining of the colon.
Gastrointestinal unit, is observed several monitors and some storage equipment
like VCR and image and video processing computer
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Click on the image to
download the video clip. To best appreciate the video, it is recommended
to first set up your media player in REPEAT and when the video is
displayed press ALT + ENTER to see it in full screen.
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Image and video of Colonoscopy.
This image shows all the structures from the anus
to the cecum.
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Image of Video Colonoscopy with Zoom.
This endoscopy sequence shows the differences between the resolutions
using
a video endoscope with Zoom.
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Video Endoscopy with Zoom. 1x. |
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Video Endoscopy with Zoom. 5x. |
Video Endoscopy with Zoom. 8x. |
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| Endoscopic image using a magnifying endoscope 150x. the
cells of a tumor are observed, Indigo carmine dye-spraying. |
Another colonoscopic image using magnifying
150x. |
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A benign tumor: sessile tubulovillous adenoma of the ileocecal
valve.
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Chromoendoscopy. |
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Tubulovillous adenoma
Video-endoscopy with chromoscopy. Magnifying endoscopy with methylene
blue demonstrates sulciform pattern. |
Chromoendoscopy and magnifying endoscopy are useful
for
detection and recognition of small non polypoid lesions, for
differential diagnosis between hyperplastic and
adenomatous lesions and for determining not only the
lateral extent but also the depth of a lesion. Pit analysis
would especially be useful in the differential diagnosis
between depressed-type early cancers (type IIIS) and flat
adenomas with pseudodepression (type IIIL). |
The colonoscopic studies are performed under mild sedation administered
by an anesthesiologist in order to make the exam more comfortable for
both the patient and the examiner. This assures a quality examination
and the possibility of finding a cancerous or pre-cancerous lesion at
an early stage of development. Other frequently found lesions are diverticulae,
polyps, ulcerative lesions and amebic ulcers, etc.
Video-Colonoscopy is an examination recommended for all persons over 40
years of age with or without symptoms. Used as a preventive medical diagnostic
exam it has enabled the discovery of many colon cancers still at a treatable
stage.
| Some frequent questions to the Physician:
Doctor, why do I have to go to the Doctor
for a Colonoscopy examination, if I don't have any symptoms at all?
Answer: You, myself or anybody are in risk of
developing a colon or rectum cancer. We don't know for sure who
will have it, but according to the American Association against
Cancer, it is recommended to have a colonoscopy study every five
years for a person over 40 years old.
The colon and rectum cancer are one of the most frequent and according
to statistics, keeps growing, regardless of gender, but it is still
the most preventive.
Which is the main purpose of this test?
Answer: The purpose is the detection of small
tumors known as polyps, which could remain undetected and grow in
the colon quietly for many years. Only some of them will show symptoms
and/or some will develop cancer.
The main purpose of the test is to detect the cancer from the beginning
o from the Polyp. Normally, when the cancer shows
the symptoms it means that it is already in its advance stage; this
is why the “complete colonoscopy” test should always
be practice every 5 years, since this type of cancer is perfectly
preventive.
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It is also worthy to reflect upon the fact that when the rectum
cancer is near the anus, the surgery performed is one of the worst
things that could happen to a person, which is to have a colostomy
for all his life. This means to defecate through a bag sticked
to his abdomen.
Besides all this advantages, we have to add that a lot of
people may get confuse and think they have hemorrhoids, and without
consulting an specialist they make a mistake to get a self-treatment
by using creams or suppositories for what they wrongly believe to
be hemorrhoids, until they finally realize it is cancer.
| Doctor, if you find through colonoscopy that
I have a polip, how are we going to eliminate it?
Luckily we can remove it without open surgery, we relay on
a very specialized equipment like the endoscopy polypectomy,
through wich very often we can cut them, with no need of open
surgery and by this procedure we will succeed in fighting
a probable cancer. We also count on an argon plasma coagulator
equipment which is combined with polypectomy that it is possible
to eliminate any Polyps of any type and size.
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Is the exam
painful? |
| Answer: Nowadays we have a modern sedatives
which are given by an anesthesiologist physician, therefore
the patient has a very comfortable time, and after the
procedure, The patient will remember nothing. In other
words, any discomfort will be eliminated by sedatives
or taken out the air that could get into the colon by
the endoscopist using the colonoscopy equipment. |
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| Colonoscopic images to see the picture bigger click
here |
Preventive Technique |
| It is “absolutely recommended”, as a way of prevention,
the practice of the colonoscopy with patients in risk of developing
a colon cancer, moreover in family patients that have had a tumor
in first degree, or in those having diseases related to a major incidence
of this type of cancer.
“In this individuals, having an early colonoscopy could detect
this small lesions that, once being remove, will prevent the development
of colon cancer, in a short or middle term”. A colonoscopy
prevents the occurrence of invasive carcinoma within 10 years, a
data that justifies itself the expenses that involve taking the
test”.
The colonoscopy is not currently a bothersome technique for the
patient, which does not prevent them to recognize that, some years
ago, when it was practiced without sedatives, it was, indeed.
“It can’t be planned any type of prevention strategy,
to an asymptomatic person if they are not assure some degree of
comfort during the practice of colonoscopy, or endoscopy. At present
time, all the explorations take place with a very short period of
sedation, as a result of what the patient has a quiet comfortable
experience, along with the fact that the tubes are more flexible
and the specialists are far more experienced. The endoscopies must
be painless, based on the assumption that we can’t give pain
to an asymptomatic patient”.
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One of the main target of the perform a complete colonoscopy
is to find colon's polyps that some but not all benign neoplasic
polyps will transform into carcinomas the "theory adenoma- carcinoma".
(The polyps can transform in a cancer from a period of two years to seven
years and most of the times make no symptoms until advanced stages are
reaches!)
If the polyps is or are founded can be removed easily by the procedure
called polypectomy.
A colonoscopy is also necessary to:
Examine patients who test positive for blood in the stool.
Check inflammatory bowel disease (colitis)
Monitor patients with a past history of colon polyps or cancer
Bleeding lesions, bleeding may occur from different points in the colon
Chronic diarrhea, constipation, or a change in bowel habits
Anemia.
Preparation To obtain the full benefits of the exam, the colon must be
clean and free of stool. The patient receives instructions on how to do
this. It involves drinking a solution which flushes the colon clean or
taking laxatives and enemas. Usually the patient drinks only clear liquids
and eats no food for the day before the exam. The physician advises the
patient regarding the use of regular medications during that time.
The Procedure Colonoscopy is usually performed on an outpatient basis.
The patient is mildly sedated, the endoscope is inserted through the anus
and moved gently around the bends of the colon. If a polyp is encountered,
a thin wire snare is used to lasso it. Electrocautery (electrical heat)
is applied to painlessly remove it. Other tests can be performed during
colonoscopy, including biopsy to obtain a small tissue specimen for microscopic
analysis. The procedure takes 15 to 30 minutes and is seldom remembered
by the sedated patient. A recovery area is available to monitor vital
signs until the patient is fully awake. It is normal to experience mild
cramping or abdominal pressure following the exam. This usually subsides
in an hour or so.
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| Images from diverticular disease, video endoscopic
study
Please click on the image to download the video clip , wait to be
downloaded
complete and press Alt and Enter to appreciate in full screen. |
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| Our colonoscopic reporter. |
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Each study of endoscopy is stored in
a DVD which we provided to the patient. |
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