How is endoscopic therapy performed?

Your endoscopic therapy will be performed in a doctor’s office, hospital, or outpatient surgical setting. Some types of endoscopic therapy use sedation or nerve block anesthesia. Some procedures are more complex and require general anesthesia and a hospital stay.

The endoscopic therapy technique varies depending on the procedure, your symptoms or diagnosis, and other factors. Endoscopic therapies are performed by inserting the endoscope through a small incision or through an opening in the body, such as the mouth: 

  • Arthroscopy involves inserting an endoscope through a small incision near a joint. It is performed by an orthopedic surgeon. It uses a general, spinal, or local anesthetic, depending on the type of procedure.
  • Bronchoscopy involves inserting an endoscope through the mouth or nose into the windpipe and lungs. It is done by a pulmonologist or a thoracic surgeon. The procedure is performed using general anesthesia or sedation, depending on the treatment. 
  • Colonoscopy and sigmoidoscopy involve inserting an endoscope into the large intestine through the anus. They are generally performed by a gastroenterologist or surgeon. A sedative is often used to minimize anxiety and discomfort.
  • Cystoscopy and ureteroscopy involves inserting an endoscope through the urethra and into the bladder and possibly the ureters. These procedures are generally performed by a urologist. A local anesthetic is used to numb the urethra.
  • Endoscopic retrograde cholangiopancreotography (ERCP) involves inserting an endoscope through the mouth into the esophagus, stomach and duodenum. A sedative is often used to reduce anxiety and discomfort. A local anesthetic may be used to numb the throat.
  • Laparoscopy involves inserting an endoscope through a small incision in the abdominal or pelvic area. It is generally performed by an abdominal surgeon, general surgeon, or an obstetrician-gynecologist. General anesthesia or spinal anesthesia is used so that you will not feel pain during the procedure.
  • Upper gastrointestinal endoscopic therapy involves inserting an endoscope through the mouth into the esophagus, stomach, and possibly the duodenum, the first section of the small intestine. It is generally performed by a gastroenterologist. Sedation is often used to reduce anxiety and discomfort. A local anesthetic may be used to numb the throat. 

Will I feel pain?

Your comfort and relaxation is important to both you and your care team. You may feel brief discomfort with some procedures. Your doctor will treat your pain or discomfort. Tell your care team if you are uncomfortable in any way.

You will have one or more of the following medications to keep you comfortable during endoscopic therapy: 

  • General anesthesia is a combination of IV medications and gases that put you in a deep sleep. You are unaware of the procedure and do not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
  • Pain medication is given intravenously (through an IV) or orally.
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
  • Sedation is usually given through an IV. It makes you drowsy and relaxed. In some cases, deeper sedation may be used, called conscious sedation. It makes you more relaxed. Patients who have conscious sedation are usually unaware of the procedure and may not remember it.
  • Topical anesthesia is applied to the surface of the skin or mucosa. Examples include gargling or spraying the throat with an anesthetic to help numb it and reduce the gag reflex.