Name of the Procedure:

Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance

Summary

Esophagoscopy is a procedure where a flexible tube with a camera (endoscope) is inserted through the mouth into the esophagus. This specific version includes injecting substances under the inner lining of the esophagus to treat or diagnose certain conditions.

Purpose

This procedure addresses various conditions affecting the esophagus, such as growths, strictures, or inflammation. The goal is to diagnose, treat, or manage these conditions by direct visualization and targeted injection of therapeutic agents.

Indications

• Persistent heartburn or GERD symptoms
• Difficulty swallowing (dysphagia)
• Suspected esophageal cancer or tumors
• Esophageal stricture (narrowing)
• Unexplained chest or abdominal pain

Preparation

• Fasting for 6-8 hours before the procedure.
• Adjustments or temporary discontinuation of certain medications, especially blood thinners.
• Diagnostic tests such as esophageal manometry or barium swallow may be required.

Procedure Description

1. Patient receives sedation or light anesthesia to ensure comfort.
2. A flexible endoscope is inserted through the mouth and gently guided into the esophagus.
3. The esophagus is examined visually for abnormalities.
4. Directed submucosal injections are administered to the targeted areas using specialized instruments passed through the endoscope.
5. The endoscope is carefully removed.

Duration

Typically, the procedure takes about 20 to 45 minutes.

Setting

This procedure is mostly performed in a hospital or an outpatient clinic with endoscopy facilities.

Personnel

• Gastroenterologist or specially trained surgeon
• Nursing staff specializing in endoscopic procedures
• Anesthesiologist or nurse anesthetist (for sedation)

Risks and Complications

• Mild sore throat post-procedure
• Bleeding at the injection sites
• Perforation of the esophagus (rare)
• Infection at the injection site
• Adverse reactions to sedation or anesthesia

Benefits

• Accurate diagnosis of esophageal conditions
• Treatment of esophageal strictures, tumors, or inflammation directly at the site
• Minimally invasive with quick recovery times

Recovery

• Observation for a few hours post-procedure to monitor for complications.
• Sore throat or mild discomfort may occur, manageable with over-the-counter pain relief.
• Most patients can resume normal activities within a day but should avoid strenuous activity for a short period.
• Follow-up appointment with the doctor to review findings and discuss further treatment, if necessary.

Alternatives

• Barium swallow X-ray study
• CT scan or MRI of the chest
• Esophageal dilation without endoscopic visualization
• These alternatives may not provide as detailed information or direct treatment capabilities.

Patient Experience

Patients might experience mild discomfort when the endoscope is inserted. The sedation or anesthesia keeps most patients comfortable and relaxed. Post-procedure, some might feel a mild sore throat or a sensation similar to having a cold. Pain management includes over-the-counter analgesics and attention to hydration and soft foods immediately post-procedure.