Since the development of modern medicine, doctors and health care professionals have always tried to come up with minimally invasive procedures for both diagnostic purposes as well as surgery. Endoscopy was developed to see inside a human body without the need for large incisions or surgery.

What is Endoscopy?
Endoscopy is a type of procedure wherein the doctor inserts a long thin tube into the body through an opening such as the mouth, anus or the urethra. Sometimes small incisions may be made on your body to insert the tube as well. The tube which is inserted within the body is fitted with a camera which allows the doctor to see what is wrong within your body, a specific section or organ. Doctors can even take images or videos of your organs which help them to determine a due course of action in your treatment. Endoscopy may also be used as a part of a laparoscopic operation to correct problems within the body, especially in cases wherein tissues have to be removed.

Types of endoscopy and its uses-
Although endoscopy could be used in any part of the body, there are certain areas where they are used more commonly than the others. Some of the types or endoscopies are mentioned below:

Colonoscopy   Used to examine your colon wherein the scope is inserted through your anus
Laparoscopy   This is one of the most common forms of diagnosis as well as surgery wherein the tube may be inserted through a small area in your abdomen or the pelvic area. This is not only used for imaging or diagnosis but is used in surgery as well.
Arthroscopy   Here, an incision is made on the joints of your body to check for problems
Cystoscopy   In this type, the tube is inserted through the urethral opening to check for problems in the urinary tract or the bladder. Another variation of this would be ureteroscopy.
Enteroscopy   This is an endoscopic examination of the intestines wherein the tube is inserted via the anus or the mouth.
Hysteroscopy   Here, examination of the uterus and the female reproductive organ is carried out wherein the endoscope is inserted into the vagina.
Bronchoscopy   It entails an examination of the lungs wherein the scope may be inserted through the nose or mouth to check the lungs
Upper gastrointestinal endoscopy - This is used for the examination of the esophagus and the upper intestinal tract.
Risks and safety-
Endoscopy is a widely performed and very reliable procedure. In the hands of a skilled doctor, endoscopy will be able to determine the cause of the problem and also correct the issues if surgery is also performed along with it. However, like any procedure, it does carry certain risks although the chances are fairly low. Some of the risks are mentioned as follows  

Perforation or other injuries to your organs such as scraping or bruising
Fever due to the introduction of foreign materials
Persisting pain in the specific area wherein endoscopy was performed
Swelling of the area wherein the tube was inserted
Infections after the procedure
Bleeding at the site of the incision or entry of the tube
However, these cases are rare and only occur in a very small section of the cases. Although there is minimal pain associated with the procedure, the benefits far outweigh the risks and inconveniences.

8 Types Of Endoscopies & For What They Are Used For!

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

Ultrasound is most commonly used to find gallstones.
In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.
Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
Patients usually have minimal post-operative pain.
Patients usually experience faster recovery than open gallbladder surgery patients.
Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.
Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.


Laparoscopic Cholecystectomy - Laparoscopic Gallbladder Removal Surgery!

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

The gall bladder, which sits just below the rib cage to the right of the stomach, is very tender to touch. It is a little sac or storage compartment for bile, which is produced by the liver. The gallbladder emits bile into the small intestines via a duct referred to as the cystic duct. The entire process is meant to break down foods (namely fatty foods). 
Gallbladder attack symptoms may include one or more of the following:
1.Pain in the back right shoulder blade:
Sometimes, pain radiates through to the back shoulder blade on the right side or in the middle between the shoulder blades. This is pain from the gallbladder affecting the back of the shoulder. This back shoulder blade chest pain is one of the most common yet unknown symptoms of a gallbladder disorder. This can come and go or be constant. It may be sharp, excruciating or dull. It may also occur especially at night. A gallbladder attack will typically last for one to four hours.
2. Pain in the stomach: 
The most common symptom of a gallbladder problem is pain. This pain usually occurs in the mid to upper-right section of your abdomen. It can be mild and intermittent, or it can be quite severe and frequent. In some cases, the pain will begin to radiate to other areas of the body, including the back and chest.
3. Nausea or Vomiting: 
Nausea and vomiting are common symptoms among all types of gallbladder problems. But only a chronic gallbladder disease may cause digestive problems, such as acid reflux, gas, nausea, and vomiting.
4. Diarrhea:
Having more than four bowel movements a day for at least three months may be a sign of chronic gallbladder disease.
5. Fever or Chills:
An unexplained fever may signal that you have a bile duct infection. If you have an infection, you need treatment before it worsens and becomes dangerous. The infection can become life-threatening if it's allowed to spread to other parts of the body.
6. Unusual Stools or Urine: 
Lighter-colored stools and dark urine are possible signs of a common bile duct block.

Recognizing The Symptoms Of A Gall Bladder Attack

Any kind of injury on the surface of the skin is immediately noticed by us, but when something happens to one of our internal organs, it can take a little longer to get to your notice for example, an obstruction in the bile duct. The bile duct is a tubular structure responsible for carrying bile from the liver and gall bladder through the pancreas to the small intestine. This bile helps the digestion process and the absorption of fat.

An obstruction in the bile duct can be triggered by a number of factors. Some of these are:

    Gallstones
    Inflammation of the bile ducts
    Cysts
    Traumatic accidents
    Bile duct or pancreatic tumors
    Hepatitis infections
    Cirrhosis or severe liver damage
    Abnormal narrowing of the bile duct

This can affect anyone, but the people who have a history of gall stones or tumors in the abdomen are at a higher risk of suffering from bile duct obstruction. Chronic pancreatitis, sudden weight loss or obesity can also increase this risk. The symptoms of biliary obstruction include light coloured stool, dark urine, pain in the upper right abdomen, nausea, vomiting and fever. Your doctor will also probably need an X-ray of the bile ducts, blood tests, a hepatobiliary iminodiacetic acid scan and ultrasonograph to confirm a diagnosis before they can start treating you for the same.

If not treated in time, bile duct blockages can lead to a dangerous buildup of bilirubin in the body and trigger a number of life threatening diseases. Treatment for biliary obstruction can be through medication or surgery with surgery being the more preferred mode of treatment. It is aimed at resolving the underlying cause of the obstruction and alleviating the blockage. Treatment for biliary obstruction can be two common forms of treatment include a cholecystectomy and ERCP. The former involves the removal of the gall bladder and is suited to obstructions caused by gallstones. The latter is a procedure to remove small stones from the bile duct or place a stent inside the duct.

There are many ways bile duct obstruction can be prevented which first and foremost includes following a healthy lifestyle. If you are overweight, exercise for at least half an hour a day to regulate your weight and reach a healthy BMI. Decrease your intake of sugar and saturated fats as both these can cause gall stones. Also, increase the amount of fibre in your diet. All the above mentioned tips will certainly help you in preventing bile duct obstruction.

Bile Duct Blockage -  8 Factors Behind it!

This surgery involves the removal of Gallbladder, which is a pear-shaped organ that lies right beneath the right side of the liver. The main function of the gallbladder is to collect and concentrate bile, which is a digestive juice produced by liver after eating, aiding digestion. The most common disorder of the digestive system is presence of Gallstones, which are the stones made up of a mixture consisting of cholesterol, bile pigment and calcium salts.

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.
Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

    The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
    A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
    Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
    Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
    In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.

Complications after gallbladder surgery:
This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:
There are three main types of gallstones. They are
1. Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
2. Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
3. Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.

Medical factors to consider before cholecystectomy:
The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:
Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week. 

Gallstone Surgery - Things You Should Know About It 

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