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Video Endoscopy of the Upper Gastrointestinal Tract
is a modern medical technology that enables us to visualize the inner
linings of esophagus, stomach and duodenum. This technology has been greatly
improved with the development of Computerized Video-Endoscopy systems
which makes high resolution visualization and imaging of the GI tract
possible. 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 swallow a thin, flexible, lighted tube with
a tiny video camera called an endoscope. Right before the procedure the
Gastroenterologist will spray your throat with a numbing agent that may
help prevent gagging. You may also receive pain medicine and a sedative
to help you relax during the exam. The endoscope transmits an images and
videos of the inside of the esophagus, stomach, and duodenum, so the Gastroenterologist
can carefully examine the lining of these organs. The scope also blows
air into the stomach; this expands the folds of tissue and makes it easier
for the physician to examine the stomach
| Upper Endoscopy (called "EGD") is an
inspection of your esophagus and stomach using a camera on a lengthy
tube that is placed down your throat. It allows doctors to find ulcers,
cancers in your upper digestive tract and is useful for explaining
bleeding, swallowing problems, or abdominal pain. |
Frequently Asked Questions about the Endoscopy Procedure
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Will I be asleep?
The sedation used for Colonoscopy and Endoscopy is called "Conscious Sedation". You will be awake and able to talk and move although you may not remember doing so afterwards.
What medications will I receive?
You will receive two medications prior to and during the procedure.
How long does the procedure take?
Colonoscopy can take from 30-60 minutes.
Endoscopy can take from 15-30 minutes.
The procedure can take more or less time and varies from person to person.
How long do I have to stay after my procedure is completed?
On average, patients are observed for 30-60 minutes (this can take longer depending on how well the patient is recovering) after their procedure. After you have had something to drink, have been able to sit up, have stable vital signs, and are able to ambulate unassisted, you and your companion will be free to leave. (You cannot leave without an adult to escort you home).
When/What can I eat afterwards?
You can eat and drink normally afterwards, although we recommend starting with a light meal and advancing your diet as tolerated.
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| Gastrointestinal unit, is observed several monitors and
some storage equipment like VCR and image and video processing computer |
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| Picture of Endoscopy, the gastric body is observed. |
Another picture of gastric body is appreciated. |
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.
:The objectives of this examination: to examine the organs already mentioned
mainly to detect gastric cancer in early stage when still hope to be cure
see Gastric
Cancer. Another objective is to value an abdominal pain and as a preventive
medical screening to all person after the forty years. Since cancer almost
never it warns in his beginnings . Another fundamental objective is the
evaluation of a bleeding , vomits of sanguineous content or black color
since we counted on the therapeutic Endoscopy with which we can stop a
Bleeding injecting by means of these equipment to the gastric varices
of the esophagus or and bleeding a gastric or duodenal ulcer, by means
of the biopsy channel a long special steel sounding is introduced which
in its internal end takes a needle and by outside a syringe is connected
(injector of varices) using a special substance, with this method we stop
the hemorrhages of the digestive apparatus superior thus saving a human
life, and of a surgery of emergency. The biopsy is the takings of samples
of small fragments which are sent to the pathologist their microscopic
examination to determine the nature of an injury at histologic and cellular
level thus determining if an injury is benign or malign. Also within the
therapeutic endoscopy, we eliminated some tumors as they are polyps polypectomy.
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Video Endoscopy with Magnifying. Duodenum
the Intestinal microvillis are observed. |
Photography of video endoscopy of hi-res is appraised
the Gastric body.
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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Argon Plasma Coagulator equipment.
We use this equipment for several purposes on therapeutics endoscopy. |
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Our Endoscopic Reporter. |
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| The patient or the referring physician get the video of
the complete endoscopic procedure, in DVD Format. |
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| In our endoscopic unit we have different kinds of endoscopes
one of them is a special endoscope with double channel for therapeutical
porposes. |
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The Gastroenterologist can also insert instruments into the scope
to remove samples of tissue (biopsy) for further tests. |
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Gastric Body that has been aprecited with the newest video
endoscopes, The IMAGENES ARE EXTREMELY CLEAR And
brilliants.
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In this endoscopic sequence are preciated the diferent resolution
between
The Zoom 1X. |
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| Zoom enhance level 5. |
Zoom enhance level 8. |
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| Another view of the gastric folders. |
Video Endoscopy with magnifying 150x. Duodenum the Intestinal
microvillis are observed. |
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Endoscopic image of the gastric body |
Radial Endosonography |
Endoscopic ultrasonography (EUS) is a combination of endoscopy and
ultrasonography, a small ultrasonic transducer being incorporated
into the tip of an endoscope. The high ultrasonic frequencies used
( 7.5 - 20.0 Mhz) provide excellent resolution, distinguishing between
structures and lesions as small as 2 - 3 mm .
As with esophageal cancer, EUS can also provide an accurate assessment
of the T-stage and, to a somewhat lesser degree, of the N-stage. EUS
has also been shown to be superior to CT in the local staging of gastric
carcinoma. Assessment of resectability is possible with high reliability.
The same problems are encountered as with high reliability. The same
problems are encountered as with esophageal cancer, such as overstaging
(which mainly occurs in ulcerated carcinomas), identification of malignant
lymph-nodes, detection of anastomotic recurrence, and restaging. Since
in the histopathological TNM classification, stages T2 and T3 are
defined as infiltration into the subserosa (T2) or serosa (T3, this
degree of accurate distinction cannot be made by means of EUS, and
the EUS results in stage T2 are therefore poorer compared to the EUS
results for the more advanced stages. EUS also seems to have difficulties
in reliably differentiating between the mucosal and submucosal forms
of early gastric cancer, although this distinction would be essential
to select patients for endoscopic resection. Il could be that higher
frequencies are more accurate in this respect. When surgery is performed
in every patient without distant metastases, EUS does not play a major
role. However, when pre-treatment protocols are applied, using neoadjuvant
chemotherapy in more advanced stages, EUS staging is crucial to select
patients for either pre-treatment or primary surgery.
Recommendations : EUS can be used in the preoperative staging of gastric
cancer in patients without distant metastases if the local tage has
an impact on therapy ( local resection, neoadjuvant chemotherapy |
EUS can be used for the preoperative staging and assessment of resectability
in operable patients without distant metastases, especially when stage-dependent
treatment protocols are applied. The role of EUS in the detection
of anastomotic recurrence and in restaging after radiochemotherapy
is still under evaluation.
Endoscopic ultrasound has evolved into a useful technology
for clinical gastroenterologists. Four applications have reached a
point of particular clinical value in the evaluation of patients with
cancer, primarily by enhancing our ability to stage patients.
Staging Gastrointestinal
Cancer |
Because most gastrointestinal cancers begin in the mucosal layer
and invade more deeply as they progress, EUS has become a powerful
clinical tool for gastrointestinal cancer staging. The ability
of EUS to image lymph nodes adjacent to the gastrointestinal
tract is also a key element in staging using the TNM staging
system. In this classification, T refers to the depth of invasion,
N to regional lymph node metastases, and M to distant metastases.
EUS, using high-frequency ultrasound, is limited in identifying
distant metastases, but has added new accuracy in the staging
of depth of penetration and regional lymph nodes.
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Radial Endosonography image and video
of the gastric body. |
Endoscopic Surgery
of the upper digestive tract
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Therapeutic Endoscopy has made possible to remove the gallstones
from the bile duct without having a scratch on the abdomen. Various
therapeutic procedures such as sclerotherapy or banding of oesophageal
varices, bleeding ulcers, dilatation of oesophageal strictures, balloon
dilation of achalasia cardia, stenting of biliary, gastrointestinal
pancreatic ductal stenosis, polypectomy, foreign body removal and
various other procedures can be performed with endoscopy. Endoscopic
treatment is much simpler as compared to surgery.
1. The Endoscopic Suturing
Transoral, flexible endoscopic suturing for treatment of GERD
ENDOLUMINAL GASTRIC PLICATION (ENDOSCOPIC SEWING).
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Now we have this new emerging tecnology Endoscopic
suturing aims to tighten the valve at the top of the stomach
and reduce acid reflux. It does not aim to reduce acid production
by the stomach. The attraction of the procedure is that chronic
prescription acid-controlling medication therapy is quite expensive
and the hope is that a single, miminally invasive procedure
might provide similar symptom relief at decreased long-term
cost.
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The endoscopic suturing
device .
For more details download the
video clip by clicking
on the image.
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| 51 year-old male with hiatos
hernia and heartburn since 3 years ago . |
This image displays the endoscopic
stitches which has tied the gastroesophageal tisues.
It places stitches in two locations near the LES,
which are then tied to tighten the valve and increase
pressure. There is no incision and no need for general
anesthesia.
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Another image. |
Patient relief his GEAR inmediatly.
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| 24 year old, female suffering gerd
since 7 years previously due to les incompetence . |
Another image of gastroesofagic
junction. |
The ESD Flexible Endoscopic Suturing
device. It uses the same principal of tightening the junction
between the esophagus and the stomach by the placement
of sutures. |
The image and the video display
the step of sucking enough tissue
(mucosa, sub mucosa and
muscularis).
The needle is then fired into the sucked tissue.
We applied the first suture with the first needle and
at the same time we removed the valve of
suction and in this way it free the
tissue from the pincer and we
prepared the field for the second
suture which is one centimeter
away from the first one. |
Both threads that have been placed
in two stiches forms a single union.
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This image displays the endoscopic
gastroplicature. |
Another image of the endoscopic
gastroplicature.
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Patient relief the
GERD.
She did not any anti reflux
pharmacological treatment
any more.
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To observe multiple images
and video clips of Endoscopy see our on-line atlas. |
| El
Salvador Atlas of Gastrointestinal Video Endoscopy. |
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