How to Choose rigid endoscopes?

Endoscopy is a minimally invasive technique for diagnosis and surgery. The endoscope can be inserted via the mouth when exploring the stomach or bronchial tubes; via the nostrils for the nasal cavities, vocal cords or sinuses; and via the anus to examine the colon. For other examinations, it may sometimes be necessary to make small incisions to insert the endoscope, for example in the abdomen (laparoscopy).

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There are three main types of endoscopes:

• The rigid optical endoscope: is a rigid rod with lenses. One end of the endoscope has the lens, and at the other end there is a socket for connecting a light source and the eyepiece. It is also possible to clip a video camera head onto it.
• The fiberscope (or flexible optical endoscope): works on the same principle as the rigid optical endoscope except that its stem is flexible because it is made of an optical fiber. This makes it easier to access sinuous areas, such as certain parts of the larynx. On the other hand, due to its thin, flexible and fragile stem, the fiberscope needs to be used more delicately.
• Video-endoscope: the rod is usually flexible and at the end of it is a CCD sensor that allows for the acquisition of video images. For certain applications (such as a polypectomy, prostate enucleation, etc.), the stem may have one or more working channels for endoscopic instruments. The handling of a video-endoscope can be delicate, especially because of the fragility of the CCD sensor at its end. Some video laryngoscopes can be rigid. They are made up of a blade and can be equipped with an integrated video monitor to enable quick viewing, especially for an emergency intubation for example.

A rigid endoscope is often used for applications where access to the inspection area is not very sinuous, such as cranial sinuses, the ear canal, urinary devices, etc. It is coupled to a light source and sometimes a video camera is attached to the lens.

It can have a wide-angle lens, which allows for wide framing of close objects. It also offers high-definition images thanks to transmission by optical lenses. The rigid structure of the endoscope is due to the succession of lenses aligned in the tube. This allows the practitioner to obtain a clear image of the inspected area.

Lastly, rigid endoscopes can have one or more channels through which an endoscopic instrument can pass. These can be forceps to grasp or remove foreign bodies or tissue samples; scissors to cut tissue; brushes to collect cells or a lace to catch polyps for example.

Each type of endoscopy has its own risks, but overall these are essentially risks related to infection. To limit these risks, the endoscope is systematically disinfected before being introduced into the body. Other accessories are also sterilized or are sometimes single use.

Depending on the part of the body examined, local or general anesthesia may be recommended. The possible risks associated with any anesthesia must therefore also be taken into account. A pre-anesthetic consultation is mandatory.

Finally, some complications can be caused by the manipulation of the endoscope itself. The risk may then be of esophageal, gastric or intestinal perforation. But these kinds of complications are very rare.

The advances made in imaging have been applied to video-endoscopes, allowing for interesting alternatives to traditional diagnosis methods:

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• Endoscopic ultrasound: mainly used in gastroenterology, particularly for the exploration of the pancreas and bile ducts, it facilitates the detection of possible tumors, gallstones, etc. by coupling an ultrasound probe to the video-endoscope. It is often more precise than MRI or CT for certain types of investigations. This technique, which combines endoscopy and ultrasound, makes it possible to visualize not only the inside of the canal but also its adjacent structures. The probe also allows you to visualize the vascularization of the tissue. Endoscopic ultrasound has some limitations, however, such as availability of the equipment, cost and the ultrasound resolution in terms of image quality. Other optical imaging techniques could therefore be developed to overcome these obstacles.

• Increasing the quality of the electronic zoom: the power of the electronic zoom depends on the resolution of the video sensor. This power is constantly increasing for new-generation video-endoscopes, thanks in particular to the use of megapixel CCD sensors.

• Autofluorescence imaging: when radiation excites tissue at a specific wavelength, certain molecules (fluorophores) will release the absorbed energy in the form of a very specific radiation. Spectrum analysis and the measurement of the emission time of the emitted radiation will make it possible to characterize its nature. This fluorescent image, when placed on top of the traditional image, helps diagnosis considerably.

The development and application of the following techniques in endoscopy are also worth noting: confocal microscopy and optical coherence tomography. Optical coherence tomography (OCT) allows for very high resolution three-dimensional analysis of tissue.

Nowadays, the medical services market is rapidly expanding, and endoscopy, being an important part of it, is no different. Endoscopy has become an integral part of different branches of medicine such as gastroenterology, pulmonology, gynecology, urology, otolaryngology, surgery and others, since it appeared in the middle of the last century. Endoscopic equipment opens wide possibilities for diagnosing various diseases, convenient screening, and effective minimally invasive medical manipulations. Many studies have shown that surgeries performed using endoscopy equipment make an extremely positive therapeutic impact and substantially lower the risk of complications.

Types of modern endoscopes

There are two main categories of endoscopes according to their design features:

• rigid endoscopes which in their turn are subdivided into two large groups: endoscopes proper which are inserted into the body through natural openings and laparoscopes which are inserted through incisions. Rigid endoscopes look like short metal tubes equipped with an illumination source and a magnifying device. Such endoscopes are widely applied in urology, gynecology, otolaryngology, and general surgery. Rigid endoscopes are the oldest type on the market. They are used in the majority of surgical endoscopic applications and enable endoscopists to visualize the surface of organs
• flexible endoscopes can reach the most distal parts of the human body, this way having an extremely important diagnostic value, especially in gastroenterology, pulmonology, and gynecology. There are two main groups of flexible endoscopes ' fiber endoscopes and video endoscopes. Fiber endoscopes are simpler in construction and are mostly used as observational devices. Video endoscopes, equipped with a video camera, a wide instrument channel, as well as water and air supply systems, are ideal devices for surgical manipulations in the examined cavity.

To make the right choice, it is important to clearly understand what the device will be used for. It is necessary to determine the manipulation types which are planned to be conducted ' diagnostic or therapeutic, as well as body regions meant to be examined.

What to pay attention to when buying?

So, what do you have to pay attention to when buying an endoscope?

• device dimensional and ergonomic features, since the equipment usability directly depends on them;
• device resolution and compatibility with modern endoscopic systems affecting the resulting image quality, and consequently, equipment working efficiency;
• angular field, focus range, and bending angle of the distal end ' the features responsible for the direction and field of view;
• instrument channel compatibility with accessories and its diameter;
• cleaning compliance and/or the possibility of full immersion in disinfectants.

The endoscopic equipment manufacturers' price policy is also worth considering. Publicly funded health care is often quite limited in financial resources, and therefore, preferences should be given to reliable devices from proven manufacturers able to provide adequate extended service maintenance for their products. Private clinics can afford using expensive cutting-edge equipment available on the market if their executive staff is sure in their commercial return.

As for the equipment brands, OLYMPUS, PENTAX, FUJINON (Japan) and KARL STORZ (Germany) are leaders in this field. Currently, Chinese manufacturers, HUGER, in particular, are actively entering the market.

More information about the best endoscopic equipment manufacturers can be found in the article "Top manufacturers of endoscopy equipment"

You can find a large choice of new and used endoscopic equipment and accessories, offered for sale in a wide price range, on the BiMedis website. Our experts will be happy to advise you on all questions that arise while choosing.