Surgery

Capsule Endoscopy
Why It’s Done (Indications) 

Used to examine the middle section of your digestive system (the small intestine), which standard gastroscopy and colonoscopy cannot reach. It helps investigate unexplained internal bleeding, suspected Crohn's disease, chronic diarrhea, or unexplained iron-deficiency anaemia.

How to Prepare (Preparations)

• Clear liquid diet starting the day before the procedure and taking laxatives to clear the bowel as instructed.
• Strict fasting (no food or drink) for at least 8 to 12 hours overnight before swallow time.
• Pause certain medications, like iron supplements, as instructed by your care team.
   

What Happens (Procedural Details)

1. You swallow a small, smooth capsule (about the size of a large vitamin pill) with a glass of water.
2. The capsule contains a tiny light, camera, and transmitter. As it is pushed naturally through your digestive tract by muscle contractions, it takes thousands of high-resolution images.
3. Images are transmitted wirelessly to a small recording device worn on a belt around your waist.
4. After 8 to 12 hours, you return the recording belt to the hospital so your doctor can review the images. The disposable capsule passes naturally and painlessly in your stool within a few days.
    

Recovery (Postoperative Care)

• You can drink clear liquids 2 hours after swallowing the capsule and eat a light meal after 4 hours.
• You may resume normal daily activities, but avoid strenuous exercise or heavy lifting while wearing the recording belt.
• Keep away from strong magnetic fields (like MRI scanners) until the capsule has been passed.
   

Risks (Potential Complications)

• Capsule retention: The capsule can become lodged in a narrowed area (stricture) of the intestine, which may require endoscopic or surgical removal.
• Incomplete examination: The capsule battery may run out before reaching the end of the small bowel.
   

Deep Enteroscopy
Single-Balloon or Double-Balloon Enteroscopy
Why It’s Done (Indications) 

Used to directly view, sample, and treat conditions deep within the small intestine. Unlike capsule endoscopy, deep enteroscopy allows the doctor to take tissue samples (biopsies), stop bleeding points, remove polyps, or stretch open narrowed passages.

How to Prepare (Preparations)

• Medications: Inform your doctor about any blood thinners or diabetes medications, as they may need temporary adjustment.
• Antegrade Approach (through the mouth): Strict fasting for at least 8 hours prior.
• Retrograde Approach (through the anus): Full bowel preparation (drinking a strong laxative solution) the day before to clean out the intestines completely.
• Discontinue blood thinners as directed if biopsy or polyp removal is planned.
   

What Happens (Procedural Details)

1. Performed under deep sedation or general anesthesia to ensure complete comfort.
2. A long, specialized endoscope fitted with an outer sliding tube is introduced through the mouth or anus.
3. The surgeon or gastroenterologist uses a "pleating" or "accordion-style" technique, inflating and deflating the balloon to gently gather the long small bowel over the scope, allowing deep navigation into the intestinal tract.
4. Once an abnormality (like a bleeding vessel or polyp) is reached, micro-instruments are passed through the scope to perform biopsies, apply heat to stop bleeding, or remove tissue.
    

Recovery (Postoperative Care)

• Rest in the recovery bay for 1 to 2 hours until the sedation wears off.
• You may feel mild abdominal bloating or pass gas as the air used during the procedure exits your body.
• Do not drive or return to work for the rest of the day if you received sedation.
   

Risks (Potential Complications)

• Abdominal sore or transient sore throat.
• Bleeding at biopsy or polyp removal sites.
• Small bowel wall tear or puncture (perforation), which is rare but requires urgent intervention.