Endoscopy is the direct visual examination of the inside of the body using an endoscope, a flexible or rigid instrument carrying a light source and camera. Because the operator can see the mucosal surface in real time, endoscopy is both a diagnostic and a therapeutic tool: tissue can be sampled, bleeding can be treated and lesions can be removed during the same procedure.
Common procedures include gastroscopy for the upper gastrointestinal tract, colonoscopy and flexible sigmoidoscopy for the lower tract, bronchoscopy for the airways, cystoscopy for the bladder and hysteroscopy for the uterine cavity. Capsule endoscopy, in which the patient swallows a camera the size of a large tablet, allows imaging of the small bowel that conventional scopes cannot easily reach.
Flexible endoscopes have long, narrow channels that cannot be autoclaved, so they undergo a strict manual cleaning and automated high level disinfection cycle with full traceability of scope, patient and washer. Failures in this process have caused documented outbreaks of resistant organisms, which is why reprocessing is treated as a core patient safety system rather than a housekeeping task.
In the UK, endoscopy services are assessed against the Joint Advisory Group on gastrointestinal endoscopy (JAG) accreditation standards, which cover clinical quality, patient experience, workforce and training. Service level metrics such as caecal intubation rate, adenoma detection rate and comfort scores are monitored because they correlate directly with the clinical benefit patients receive.
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