Gastroscopes

Gastroscopes are endoscopic instruments used to examine the upper gastrointestinal tract, including the esophagus, stomach, and duodenum. They may be rigid or flexible, with modern devices typically flexible and video-based. A gastroscope is a long tube with a distal camera and light source, a control handle, and one or more working channels that permit air or carbon dioxide insufflation, suction, irrigation, and the passage of biopsy forceps, snares, and other instruments.

The examination, esophagogastroduodenoscopy (EGD), is performed in an endoscopy suite under sedation or anesthesia. The mouth is opened, the scope is advanced through the esophagus into the stomach and duodenum, and real-time images are viewed on a monitor. The working channel allows sampling tissue (biopsies), removing polyps, dilating strictures, retrieving foreign bodies, and achieving hemostasis or other therapeutic interventions.

Indications include dysphagia, persistent upper abdominal pain, suspected upper GI bleeding, refractory reflux symptoms, and surveillance of Barrett's esophagus or gastric ulcers, as well as evaluation after treatment. Contraindications include conditions that raise the risk of perforation or anesthesia complications, such as severe cardiopulmonary instability, uncontrolled coagulopathy, or known obstructions that prevent safe passage; pregnancy is evaluated on a case-by-case basis.

Risks: Most patients experience only a mild sore throat or transient gagging. More serious but uncommon risks include bleeding, perforation, infection, aspiration, and adverse reactions to sedation or anesthesia.

Variants and history: Modern gastroscopes are high-definition, fiber-optic or digital video devices with imaging enhancements and multiple channels. Disposable single-use gastroscopes are available to reduce infection risk. The transition from rigid to flexible endoscopes in the mid-to-late 20th century greatly expanded diagnostic and therapeutic capabilities.