What is Endoscopic Examination?
Endoscopy is a medical diagnostic and therapeutic method in which a slender, flexible tubular instrument (known as a medical endoscope) is inserted into natural body cavities (such as the mouth or anus), allowing doctors to observe internal structures and organs directly. The end of the instrument is typically equipped with a light source and a miniature camera. Using fiber optic endoscope technology, light and images are transmitted to an external monitor, displaying clear internal visuals—endoscope images—in real time. Doctors analyze these images to assess tissue conditions.
Why should endoscopy be performed?
Endoscopy is essential for several key reasons:
- It is the gold standard for direct visualization of internal cavities, capable of detecting early and subtle lesions.
- Minimally invasive—usually requires only mild sedation.
- Enables real-time biopsy of suspected lesions during examination for pathological analysis.
- Allows therapeutic procedures using miniature instruments during examination.
What can endoscopy detect?
Endoscopy can visually identify various internal pathological features:
- Signs of mucosal inflammation or abnormal damage.
- Various types of ulcers, including gastric and duodenal ulcers.
- Polyps or masses, as well as preliminary identification of proliferative tissue.
- Direct visualization of tumor morphology, location, and extent.
- Bleeding points and vascular abnormalities.
- Foreign bodies causing obstruction or abnormal narrowing.
- Structural anomalies or variations in organ morphology.
Core Endoscopy System Equipment
1.Endoscope
Types of Endoscopes
Flexible Endoscope: Equipped with a bendable insertion tube, suitable for curved cavities, such as gastroscopes and bronchoscopes.
Rigid Endoscope: Have a rigid structure, typically inserted through surgical incisions or straight cavities, such as laparoscopes, arthroscopes, and some cystoscopes.
Laryngoscope: Used specifically for examining the larynx and tracheal entrance.
- Video Laryngoscope display the intubation process on a screen.
- Disposable Laryngoscope is designed for single-person, easy operation and infection prevention.
Colposcope: Used for magnified examination of the cervix and vaginal walls.
- Digital Colposcope output digital images.
- Optical Colposcope is used with direct visual observation via eyepiece.
A complete endoscope parts:
Endoscope Body: The part held by the operator, including eyepiece interface, control knobs, and valve ports.
Insertion Tube: A soft or rigid slender tube inserted into the body, containing light bundles, image fibers, and working channels.
Distal Tip: The head at the front end of the insertion tube, housing imaging and illumination components.
Objective Lens: Located on the distal tip, responsible for capturing the target image.
Angulation Control: Control knobs or wheels located on the body, used to bend the distal end of flexible scopes for multi-angle viewing.
2.Light Source
Endoscopic illumination relies on high-intensity light sources. Halogen and xenon lamps were widely used earlier, with xenon providing higher brightness and better color temperature. Currently, LED light sources are increasingly adopted for their stable, efficient, low-heat output and long lifespan.
3.Camera System
For camera-equipped scopes such as electronic endoscopes, the video processor is essential. It receives photoelectric signals from the scope, performs key image enhancements (e.g., color balance, white balance, sharpness, contrast), and outputs high-quality digital video signals.
4.Monitor
The dynamic endoscopic images generated by the video processor require display equipment. High-resolution medical monitors provide sharp, accurate visuals for real-time observation and diagnosis.
5.Suction System(Suction pump+Perfusion pump)
During procedures, fluids, blood, or secretions must be removed to maintain clear visibility. The suction system, primarily the suction pump, handles this. It both pressurizes irrigation fluid and applies vacuum suction to remove fluids and debris. Perfusion pumps are also used where precise fluid control is required.
6.Pneumoperitoneum Machine
Used in procedures like laparoscopy to inflate the abdominal cavity with CO₂ gas at controlled pressure and flow, creating an operative space while maintaining internal environment stability.
7.Trolley Cart
To integrate and manage the core devices, a mobile trolley carries components like the light source, Camera System, monitor, pneumoperitoneum machine, suction pump, and device interfaces for efficient and safe procedures.
8.Endoscopy Accessories
Biopsy Forceps: Precisely extract tissue samples for pathology.
Cleaning Brushes: Remove debris or mucus from channels or components.
Ligation Devices: Tools like ligators for tying vessels or lesions (e.g., hemorrhoids, varices).
Scissors and Cutters: For intra-cavity tissue cutting and resection.
Tubing Sets: Include irrigation, suction, and insufflation tubes.
Stapler: Used for suturing and anastomosis during minimally invasive surgery.
9.Related Equipment
Leak Detector: Automatically tests endoscope sealing after each use to prevent fluid damage—crucial for safe maintenance.
Endoscope Cabinet: Provides clean, dry, ventilated storage with UV or ozone disinfection, preventing contamination or damage.
Endoscope Washer and Disinfector: Performs standardized automated cleaning and disinfection cycles, including multi-tank rinsing, enzymatic wash, disinfectant soaking, and final rinse—meeting stringent infection control standards.
Types of Flexible Endoscopy Equipment
Gastroscope: For inspecting the esophagus, stomach, and duodenum; enables biopsy and some treatments.
Bronchoscope: Enters the trachea and bronchial tree to inspect lung lesions, remove foreign bodies, or collect samples.
Flexible Cystoscope: Enters the bladder via the urethra; flexible for more comfort, suitable for outpatient or unsedated exams.
Enteroscopes:
- Colonoscope:Examines the entire colon up to the ileocecal valve.
- Small Intestine Endoscope: For partial or full small intestine inspection.
Cholangiopancreatoscope: Accesses bile or pancreatic ducts intraoperatively or postoperatively.
Nasopharyngoscope: Examines nasopharynx and larynx via the nasal cavity.
Ureteroscope: Enters the ureter and renal collecting system via the urethra and bladder—for stone removal or stricture treatment.
Types of Rigid Endoscopy Equipment
Arthroscope: Minimally invasive instrument for joint inspection and surgery (e.g., knees, shoulders).
Hysteroscope: Inserted through the cervix into the uterine cavity to examine the endometrium, tubal ostia, and cavity shape; allows polyp removal and adhesion separation.
Laparoscope: Enters abdominal cavity via small abdominal incisions; used in hepatobiliary, gastrointestinal, and gynecological surgery.
Thoracoscope: Enters pleural cavity via intercostal incision to diagnose and treat pulmonary, pleural, and mediastinal diseases.
Rigid Cystoscope: Metal straight-tube scope inserted through the urethra into the bladder—for inspection, lithotripsy, and tumor resection.
Otoscope: Small rigid scope for examining the ear canal and tympanic membrane; assists middle ear surgery.
Proctoscope: Short straight-tube scope for rectal examination—screening hemorrhoids, polyps, or tumors.
Spinal Endoscope: Accesses the spinal canal or disc via percutaneous route for nerve decompression or disc removal.
Types of Endoscopy Application
Gastrointestinal
- Diagnose/treat esophageal, gastric, and duodenal lesions (e.g., precancerous lesion removal, hemostasis).
- Colorectal cancer screening and polypectomy.
- Small bowel lesion diagnosis (e.g., capsule endoscopy).
- ERCP for biliary and pancreatic diseases.
Ear
- Observe ear canal inflammation and foreign bodies.
- Tympanic membrane repair and middle ear microsurgery.
Respiratory
- Biopsy of trachea/bronchial lesions and bronchoalveolar lavage.
- Mediastinal lymph node sampling and lung cancer staging.
- Laser ablation or stent placement for airway stenosis.
Female Reproductive
- Colposcopic biopsy of cervical precancerous lesions.
- Hysteroscopic adhesion separation and submucosal fibroid removal.
- Fallopian tube patency check and infertility treatment.
Urinary Tract
- Bladder tumor resection and lithotripsy.
- Ureteral stricture dilation and renal stone laser lithotripsy.
- Transurethral resection for BPH.
Minimally Invasive Surgery
- Laparoscopic cholecystectomy and gastrointestinal tumor resection.
- Arthroscopic meniscus repair and ligament reconstruction.
- Thoracoscopic lobectomy and mediastinal tumor removal.
- Spinal endoscopic discectomy.
Supporting Technologies
High-frequency electrosurgical and ultrasonic scalpels; narrow band imaging for vascular enhancement; fluorescence navigation for lymph mapping; intraoperative frozen pathology for rapid decision-making.
Frequently Asked Questions
What are the most essential endoscopy devices for a new clinic?
Prioritize systems with broad diagnostic coverage and high usage frequency:
- GI endoscopy system (gastroscope + colonoscope + processor + water pump): covers upper GI and colorectal needs—accounts for >70% of internal medicine procedures.
- Portable rigid cystoscope:low cost, easy maintenance, ideal for quick urology assessments.
- Basic cleaning and disinfection (leak detector+ washer-disinfector): crucial for infection control—higher priority than high-end therapeutic endoscopes.
Note: OB/GYN clinics require hysteroscopes; respiratory clinics need bronchoscopes. In early stages, avoid scattered purchases—focus resources on establishing complete workflows for core departments.
How often should endoscopy equipment be replaced or serviced?
Maintenance cycles depend on usage intensity and care level:
Preventive Maintenance:
▶Optics checked monthly for clarity
▶Leak test quarterly (monthly for high-use departments)
Key Component Lifespans:
▶Flexible insertion tube rubber: ~800 insertions
▶Fiberoptic bundles: 3–5 years (20% light loss)
▶CMOS sensors: ~5 years aging
Mandatory Decommissioning:
▶Rusted/damaged rigid scope body
▶Flexible channel wall thinning after multiple repairs
▶Discontinued models without spare parts
What safety standards must be verified when selecting an endoscopy supplier?
Three-tier compliance verification:
- Basic Qualifications:
-ISO 13485 certification
-NMPA registration (verify model match)
-CE/FDA marks (mandatory for export)
- Infection Control Certification:
-Washer-disinfectors certified to EN ISO 15883
-leak detectors meet YY/T 0287 tolerance
- Clinical Safety Standards:
-Infrared filters in light source (prevent tissue burns)
-Medical-grade isolation in electrical systems (anti-leakage)
-Complete biofilm removal validation report
Supplier Value Additions:
- Technical training access to reduce service dependency
- Local spare parts warehouse with <72 hr downtime
- Shared failure rate data for same model across institutions