Biomedical Engineering Department

BMEG3183: Bio-optics
Chapter 5: Endoscope

By: Molla M.
Endoscopy
 What is Endoscopy?
 The word endoscopy is derived from the Greek words.

 "Endo" meaning "inside" and

 "skopeein" meaning "to see".

 Describe the procedure used see inside various parts of the body.

 Endoscopy is a nonsurgical procedure.

 A flexible tube with a light and camera attached to it.

 The doctor can view pictures of your digestive tract on a color TV monitor.
 Cont’d
 It is a procedure used to view and
operate on the internal organs
and vessels of the body.
Cont’d
 A minimally invasive diagnostic medical procedure
 Gives visual evidence of the problem (e.g. cancer, ulceration or
inflammation)
 Can be used to collect a sample of tissue or remove problematic tissue
 Used to take photograph of the hollow internal organs
 Performed under

– Conscious sedation (conscious sleeping)

– Total Anesthesia
Cont’d
 Physicians use endoscopy to diagnose, monitor, and surgically treat
various medical problems
 A surgeon introduces the endoscope into the body either through a
body opening, such as the mouth or the anus, or through a small
incision in the skin
 The endoscope
 A slender, flexible or rigid tube

 Equipped with lenses and a light source.

 CCDs are used to feed a video to the monitor

 Through the accessory channels of the endoscope water and air is supplied to wash
and dry the surgical site.
 Also has a channel through which surgeons can manipulate tiny instruments, such
as forceps, surgical scissors, and suction devices.
 A variety of instruments can be fitted to the endoscope for different purposes
 Cont’d
 Medical endoscopy really came into its own after the invention and
application of fibre-optic technology to endoscopy.
 Fibre-optic endoscopes use bundles of thin glass fibres to transmit
light to and from the organ being viewed.
 These fibres use the principle of total internal reflection to transmit
almost 100 % of the light entering one end to the other end.
 Fibre Optics

 Light is shone along a thin glass fibre and as it hits the glass-air boundary at
more than the critical angle it reflects along inside the fibre.

 The bundles are often called light pipes but you must realize that they are not
really a pipe.
 There is no hollow tube down the Centre, each fibre is solid glass
 Construction of Endoscope
 An endoscope can consist of:
 A rigid or flexible tube.

 A light delivery system to illuminate the organ or object under inspection.

 The light source is normally outside the body and the light is typically
directed via an optical fiber system.
 A lens system transmitting the image from the objective lens to the viewer,
typically a relay lens system in the case of rigid endoscopes or a bundle of
fiber optics in the case of a fiberscope
 Cont’d
 An eyepiece.

 Modern instruments may be video scopes, with no eyepiece.

 A camera transmits image to a screen for image capture.

 An additional channel to allow entry of medical instruments or

manipulators
Optical Components of Endoscope

 A thin, long flexible tube.

 A lens or lens system

 A light transmitting system

 The eyepiece

 Camera
Rigid and Flexible Endoscope
The Flexible Endoscope

1. Fiberoptic instruments
 Based on optical viewing bundles

 2–3mm in diameter and contains

20000–40000 fine glass fibers, each close

to 10μm in diameter
 Fiberoptic bundles are extremely flexible
The Flexible Endoscope

Parts of the endoscope

• Control Section

• Connector Section

• Insertion Section
 The Flexible Endoscope
1. Control section
• Held in the operator's left hand
• Has two stacked angulation control knobs
direct up/down and left/right deflection of the endoscope tip.
• Has air/water and suction valves
• Has remote switches to modify or capture the video image.
• Has entry port to the instrument channel(s)
• Fiber optic instruments have an eyepiece located at the top of the control
section for direct image viewing
The Flexible Endoscope
2. Insertion Section
 The portion of the endoscope that is inserted into the patient

 The insertion tube contains

One or two instrument channel(s)

One or two light guide bundles

An air channel, a water channel

 Either an image guide bundle or a CCD chip with wire

 Connections, and angulation wires

The Flexible Endoscope
Endoscopic Accessories
 Biopsy forceps
 Graspers
 Baskets
 Injectors
 Dilators
 Knives
 Accessories
 Too many types of accessories
Cont’d
3. Connector section
 A light guide

 An air-pipe

 Electrical contacts compatible with the processor/light source.

 Side connectors for a water container, suction, insertion tube venting

 An S (safety)-cord connecting mount, which grounds the endoscope,

reducing the electrical shock hazard to the operator
Connector section
The Rigid Endoscope
 A lens system transmitting the image to the viewer
 Typically a relay lens system
 Rod lenses provide for better image quality and light efficiency
 Different diameters and viewing angles
 The Flexible Endoscope
Flexible Endoscopy Rigid Endoscope

• Laryngoscopy (vocal cords) • Laparoscopy (Abdomen)

• Bronchoscopy (lungs) • Arthroscopy (Joint)
• Colonoscopy (colon) • Endourology (Urinary tract)
• Esophagoscopy (esophagus) • Gynecological endoscopy
• Gastroscopy (stomach) • E.N.T (ear, nose and throat)
applications
• Hysteroscopy (uterus)
• Proctoscopy (anus or rectum)
• etc.
• etc.
 Why Endoscopy?
 Endoscopy is used to diagnose and treat:
 Why Endoscopy?
 Endoscopy is used to diagnose and treat:
 Why Endoscopy?
 Endoscopy is used to diagnose and treat:
 How does endoscope work?
 Step 1: Sedatives are administered.
 Step-2: Surgeon inserts an endoscope to access the target site through
a small cut or an opening.
 Cont’d
 Step 3: Tissue samples are collected by passing surgical instruments
through the tube
 Limitations of Endoscopy

 Compared with other parts of the digestive tract, the small intestine is
difficult for doctors to access.
 While a camera-tipped tube slipped down the throat can get images of
the stomach and a tube inserted at the other end of the tract reveals the
large intestine, no such device reaches into most of the small intestine.
 So, doctors rely on externally generated images
 Risks
 The main risks are infection, over sedation, perforation, or a tear of the
stomach or esophagus lining and bleeding.
 Although perforation generally requires surgery, certain cases may be treated
with antibiotics and intravenous fluids.
 Occasionally, the site of the sedative injection may become inflamed and
tender for a short time.
 This is usually not serious and warm compresses for a few days are usually
helpful
 Medical Uses
 Investigation of symptoms
 Nausea (sensation of wanting vomit)

 Abdominal pain,

 Difficulty swallowing and gastrointestinal bleeding

 Conformation of diagnosis
 Anemia, bleeding, inflammation and cancer of the digestive system

 Giving treatment
List of the major types of endoscopy
• Gastroscopy: To see the gullet, stomach and upper small intestine.

• Colonoscopy: To see the large intestine.

• Laparoscopy: To see the "stomach cavity" and the organs therein.

• Proctoscopy: This is used to check for piles and other conditions of

the anus and rectum.

• Cystoscopy: To see the urinary bladder.

 Cont’d

• Bronchoscopy: To see the air passages to the lungs.

• Laryngoscopy: To see the larynx or voice box.

• Nasopharyngoscopy: To see the nose and related cavities.

• Arthroscopy: To see inside joints such as the knee joint.

• Thoracoscopy: To see inside the chest cavity

Latest techniques in endoscopy

1. Capsule endoscopy

• A capsule with tiny camera is swallowed

that transmits the images as

it passes through.

• The camera is with 160 degree FOV

• Can give you 3D image

Latest techniques in endoscopy

2. Endoscopic retrograde cholangiopancreatography (ERCP)

• Endoscopy and x-ray are

combined to treat pancreatic

and bile disease

Latest techniques in endoscopy

3. Chromoendoscopy

• Dyes are installed before endoscopy to

identify any lesions.

• Staining the colon cancer with blue dye

Latest techniques in endoscopy
4. Endoscopic ultrasound

• High frequency sound waves are

used to identify the digestive system

and lung diseases.

• Used for pancreatic biopsy.

• Light replaced by US
 Capsule endoscopy

• It is the latest technique that uses

small-sized video capsule to

examine the digestive tract

How capsule endoscopy works?

• Sensors are attached on the chest and

stomach area with a data recorder

attached to a belt around the waist

How capsule endoscopy works?
• Capsule that contains camera is swallowed.

• The swallowed capsule transmits video

images to the data recorder.

• The recorded images are displayed

on the computer.

• It is used to examine the areas of

small intestine that cannot be seen by

other types of endoscopy

 Structure of Capsule
• The device used in Capsule Endoscopy is 25mm long

• The outer shell is made up of biocompatible material

• As it is very small in length it can be swallowed vertically

• Its diameter is about 10mm very much less than the length of it

• It helps us to swallow easily and it can easily travel through our esophagus
easily because of its structure

• It looks like a small tube

Components of Capsule
• Optical dome – used to focus the internal parts of the body in dark

• Vision module - A CCD image sensor is used in the capsule. This results in superior
image quality.

• Battery - silver oxide battery gives the 5hrs continuous power supply for the device

• Communication module - used to receive and transmit signals from the external devices

• Sensor module – Sensors convert physical properties such as light, pressure, or

temperature into electrical signals.

• CPU Module – digitizes the signal provided by sensor and vision module
Cont’d
Any Questions
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