Download Having a panendoscopy - Imperial College Healthcare

This leaflet provides information about having a panendoscopy. We hope it answers some of the
questions that you or those who care for you may have. This leaflet is not meant to replace the
discussion between you and your medical team but to help you understand more about what is
discussed. If you have any concerns about your illness or treatment please contact your surgeon,
head and neck clinical nurse specialist (CNS) or key worker. Contact details for your CNS/keyworker
are listed on page 3.
A panendoscopy is a surgical procedure that aims to get a better view of the inside of your throat and
upper oesophagus (sometimes called the gullet). It is performed under general anaesthetic.
This procedure is planned because you have signs or symptoms that require further investigation,
which cannot be carried out whilst you are awake. A panendoscopy is a diagnostic procedure which
will provide a better view of your throat, voice box and oesophagus. If an area of abnormality is
discovered, further investigation or treatment may be necessary.
Consent
Before treatment begins you will be asked for your permission (consent) for the hospital staff to
perform this procedure. Your doctor and/or clinical nurse specialist/key worker will carefully explain
what is involved (details will vary according to each individual case). No medical treatment can be
given without your consent.
If you do not understand what you have been told, let the staff know straight away so they can clarify.
You may also find it useful to write a list of questions before your appointment and to have a relative
or friend with you to help you remember the discussion when the treatment is explained.
You will receive a copy of all communications sent to your GP. Please let us know if you would prefer
not to receive this.
The surgery is performed under a general aneasthetic. Once you are asleep, the surgeon will place a
metal tube through your mouth, pointing toward the area they wish to examine. A microscope is then
used to look more closely into the voice box/oesophagus/back of the throat.
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If there is an area that looks abnormal, a small sample (biopsy) will be taken and sent away to be
examined in a laboratory. In some circumstances a laser might be used to obtain the biopsy or to
remove the tissue/abnormality itself.
As with any operation, there is a small risk associated with having a general anaesthetic. However, a
panendoscopy is generally a safe and quick procedure.
You may have a sore throat afterwards. There is also a very small risk that the metal tube placed
through your mouth could chip one or more of your teeth. A gum guard is used during the procedure
to reduce this risk as far as possible.
If a biopsy is taken from the oesophagus, or if the oesophagus needs to be stretched, there is a small
risk of tearing the lining. A tear can cause a leak in the wall of the oesophagus. If a leak occurs you
will need to stay in hospital and not eat or drink whilst it is healing. You will need to be fed through a
feeding tube that is placed through your nose down into your stomach. This is known as an NG or
nasogastric tube. After several days you will be allowed to start taking sips of water and then
gradually build up to a normal diet.
You will be asked to come in on the day of your surgery having fasted at home beforehand. You may
be asked to attend at 07.00, although your slot on the operating list might be later on in the day,
perhaps not until the afternoon. It is not possible to arrange the order of the list in advance because
there can be urgent admissions and the length of time needed for each person’s surgery also tends
to vary. Unfortunately, this can mean an unavoidable wait until you are taken to theatre.
If you are placed later on the list the nursing and aneasthetic staff will let you know if you can have
some water while you wait. You can bring a friend or relative along when you come in and they can
wait with you.
You will be seen by the operating team and aneasthetist before your surgery and the ward nurses will
help you prepare for theatre. They will take you to theatre when it is your turn to go.
You will be taken to the aneasthetic room and placed under aneasthetic. Following the procedure you
will be moved to the recovery area and later transferred to the day surgery unit or ward.
As the procedure involves having a short anaesthetic, you may feel a little tired afterwards. You may
also experience a sore throat from where the tube was passed through your mouth, particularly if a
biopsy has been taken. Please let nursing staff know if you are experiencing any pain or if you have
any concerns.
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You should be able to go home after a few hours of recovery, providing you are able to eat and drink
and feel well enough. You will need a responsible adult to accompany you home and must
make appropriate travel arrangements. Someone will also need to be with you at home overnight.
When you leave hospital, you will be given a discharge summary and any medications or painkillers
you need. You should also be given information about any follow-up appointments.
You should wait at least 24 hours after your operation before driving. Please check with your
insurance company for further guidance on this if you are unsure.
Depending on your job, you should be able to return to work following a few days of recovery.
Should you have a problem with breathing, or experience chest pain you are advised to go directly to
the A&E department.
If you feel generally unwell or experience a raised temperature please contact your GP, or call 111 if
it is outside of normal working hours.
If you have any concerns following your operation, you can telephone the head and neck CNS on
020 3311 0115. Alternatively, you can telephone the Ear, Nose and Throat (ENT) clinic on
020 3313 5584, or the head and neck ward (10 south) on 020 3313 1958 or 020 3313 1961.
We aim to provide the best possible service and staff will be happy to answer any of the questions
you may have. If you have any suggestions or comments about your visit, please either speak to a
member of staff or contact the patient advice and liaison service (PALS) on 020 3313 0088 (Charing
Cross, Hammersmith and Queen Charlotte’s & Chelsea hospitals), or 020 3312 7777 (St Mary’s and
Western Eye hospitals). The PALS team are able to listen to your concerns, suggestions or queries
and are often able to help sort out problems on behalf of patients.
Alternatively, you may wish to express your concerns in writing to:
The chief executive’s office
Imperial College Healthcare NHS Trust
Trust Headquarters
The Bays, South Wharf Road
London W2 1NY
This leaflet can be provided on request in large print, as a sound recording, in Braille, or in alternative
languages. Please contact the communications team on 020 3312 5592.
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Head and neck
Published: November 2014
Review date: November 2017
Reference no: 2517
© Imperial College Healthcare NHS Trust