General information about endoscopy

1. ENDOSCOPY
ALİ ÖZCAN ÜNAL
NECDET GÜVEN
MAHMUT KAMALAK

2. What is the Endoscopy ?
DEFINITION:
• An endoscopy is a procedure in which your doctor uses specialized
instruments to view and operate on the internal organs and vessels of
your body.

3. HISTORY
• The name endoscopy is a general expression. Modern endoscopy has
come to the present, with significant advances in a process that
began in 1959 with Harold H. HOPKINS (1918-1994) finding the rod-
shaped optical system and in 1960 with Karl STORZ (1911-1996)
adding the fiber optic light system. .

4. Why do we need an endoscopy?
• Endoscopy is typically used to:
• help your doctor determine the cause of any abnormal symptoms you’re
having
• remove a small sample of tissue, which can then be sent to a lab for further
testing; this is called an endoscopic biopsy
• help your doctor see inside the body during a surgical procedure, such as
repairing a stomach ulcer, or removing gallstones or tumors

5. Your doctor may order an endoscopy if you’re having symptoms of any of the
following conditions:
• inflammatory bowel diseases (IBD), such as ulcerative colitis (UC) and Crohn’s disease
• stomach ulcer
• chronic constipation
• pancreatitis
• gallstones
• unexplained bleeding in the digestive tract
• tumors
• infections
• blockage of the esophagus
• gastroesophageal reflux disease (GERD)
• hiatal hernia
• unusual vaginal bleeding
• blood in your urine
• other digestive tract issues

6. Where is endoscopy used in the body?

7. TYPES OF
ENDOSCOPY

8. PARTS OF ENDOSCOPY
Endoscopic
Camera
Light Source InsufflatorEndoscopy Tower
System

9. PROCESS OF ENDOSCOPY TOWER SYSTEM
• Endoscopy Tower System offers facilities a simple, high-quality
solution for all of their endoscopic imaging needs. Each component —
camera, light source, monitor and insufflator — fits conveniently into
the mobile cart for maximum portability.

10. Endoscopıc Camera
Ø The basic camera system consists of three
parts:
• A.Camera Head
• B.Processor (CCU)
• C.Monitor

11. A. Camera Head
ØThe camera head is the part
where the telescope is
attached, the image is
processed and sent to the
camera control unit (CCU).
ØCamera head has different
functions control buttons :
• I.Optical zoom
• II.Focus settings

12. CCD Sensors (Charged
Coupled Devıce)
• The camera head has a CCD sensor.
• CCDs are sensors used in digital cameras and
video cameras to record still and moving
images.
• The CCD sensor sends the image to the
CCU as analog or digital.

13. • A single sensor or three sensor structure on
the camera head affects image quality.

14. CCD sensor Study
• On the CCD sensor front
panel, there are photo
diodes that detect light
signals and transmit
electrical signals.
• The value of the voltage
obtained in the photo diode
is directly proportional to
the value of the light
intensity falling on the photo
diode.
• When the light intensity
falling on the photo diode
increases, the
voltage transmitted by each
photo diode increases

15. The most basIc terms to learn about a camera and choose
the rıght camera ın use:
• Sensitivity
• Signal to noise ratio
• Automatic Gain Control
• Resolution

16. CMOS sensor
• •A CMOS sensor is an
electronic sensor that
converts photons to electrons
for digital processing.

17. Dıfferences between CCD and CMOS sensors

18. Telescope-optıc endoscope
• Telescopes are used to obtain the desired image
in the body and to perform the necessary
interventions and operations with the help of
this image.
• •Telescopes are named according to the area
they are used in and are designed in a different
structure according to the place of use.
• •Basically, telescopes are collected under two
headings. These are rigid telescopes and
flexible telescopes.

19. Rıgıd Telescopes
• Rigid telescopes are endoscopes that are not
flexible in structure.
• It consist of these parts:
• I.Eye part (ocular)
• II.Light source (fiber optic cable)port
• III.Lens

20. FlexIble Telescope
• Flexible telescopes conduct image and light transmission with fiber
optics.
• Since it has a folding structure, it is used for imaging and surgical
intervention in many parts of the body.
• Flexible telescopes can be used conventionally.
• The flexible telescope has a cold light channel, biopsy channel, image
channel and anti-fog air channel for image surface cleaning.

21. LİGHT SOURCE
1. One of the two main endoscope cables carries light from a
bright lamp in the operating room into the body, illuminating
the cavity where the endoscope has been inserted.
2. The light bounces along the walls of the cable into the patient's
body cavity.
3. The diseased or injured part of the patient's body is illuminated
by the light shining in.
4. Light reflected off the body part travels back up a separate
fiber-optic cable, bouncing off the glass walls as it goes.
5. The light shines into the physician's eyepiece so he or she can
see what's happening inside the patient's body. Sometimes the
fiber-optic cable is directed into a video camera (which displays
what's happening on a television monitor) or a CCD (which can
capture images like a digital camera or feed them into a
computer for various kinds of image enhancement).

22. Light Source
Ø Since lighting with bulbs at the end of
the endoscope or laparoscope causes
heat trauma, the concept of cold light
was born with the use of fiber optic
glass fibers.
 Cold light source cable is two types:
1. Glass fiber cable
2. Crystal liquid cable

23. Insufflator
The abdomen is inflated by
pumping CO2 gas into the
abdominal cavity between
the visceral and parietal
leaves of the peritoneum.
The abdominal wall is
tightened to provide the
necessary space for image
and manipulation during
laparoscopic intervention.

24. RISKS
• The main risks are infection,
over-sedation, perforation, or
a tear of the stomach or
esophagus linig 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

25. Trends and
future

26. • Capsule endoscopy was first
used in humans in 1999.
• It is used in electronic circuit
and camera, gastroscopy and
colonoscopy procedures
placed in a small capsule with
micro electromechanical
technology.
• Capsule endoscopes are
swallowable like a pill. The
image taken with the

27. Da Vinci SurgIcal
System
• In emerging systems, endoscopic
methods made by remote controlled
robotic arms are used instead of the
doctor's control of endoscopy. While
the doctor is in the control room, the
patient is at the operating table.
• Not really a robot!
Master-slave system – the surgeon
directly initiates all the movements off
the robotic instruments in real time.

28. Da Vinci Surgical System
• IMAGING
• Double lenses laparoscope
• 3D , high definition, binocular view
• 10-15X magnification

29. Da Vinci Surgical System
DaVinci Offers
• Improved dexterity
• Better control
• Better precision
Advantages
• Reduced hospital stay
• Less staff required
• Less risky
!!!! Of course, there are some
limitations!!!!

30. QUESTIONS 3)Which type of system does Da
Vinci have ?
A)Master-Master system
B)Master-Slave system
C)Slave-Slave system

31. ANSWER IS B

32. references
• https://www.1stvision.com/machine-
vision-solutions/2019/07/benefits-of-
cmos-based-machine-vision-cameras-vs-
ccd.html
• http://www.megep.meb.gov.tr/mte_progr
am_modul/moduller_pdf/Endoskopik
• https://www.explainthatstuff.com/endosc
opes.html
• https://www.slideshare.net/sathishsak/en
doscopy-82816596
• www.artroskopi.org
• www.biyomedikal.org
• www.gata.edu.tr
• www.tse.org.tr