Diagnostic Tests & Investigations
ENDOSCOPY
An endoscopy is a medical procedure, which is used to examine the inside of the body. During an endoscopy the physician will insert a long flexible tube with a light source (an endoscope) into the body to examine a specific location. This is a routine non-surgical procedure used to diagnosis and monitor cancers.
There are different types of endoscopies, depending upon where exactly in the body the patient will be examined. Types of endoscopy offered at the hospital include:
- Colonoscopy
- Colposcopy
During an endoscopy a sample of tissue may be taken from the organs – this is called a biopsy. This sample is used for further diagnostic analysis by the Histology Department.
A colonoscopy is a routine test that involves the examination of the colon, also known as the large intestine. During this procedure a long flexible tube with a light source (endoscope) is inserted into the anus to examine the bowel. This non- surgical procedure is carried out by the doctor in order to diagnosis and monitor cancers of the colon.
A colposcopy is a routine test that involves the examination of the female cervix. During this procedure a long flexible tube with a light source (endoscope) is inserted into the vagina to examine the cervix. This is a non-surgical procedure carried out by the doctor, usually the gynaecologist to diagnosis and monitor cancers of the cervix.
LAPAROSCOPY
A laparoscopy is a minimally invasive surgical procedure used to examine the inside of the body. The technique is used to diagnosis and monitor different types of cancers. During a laparoscopy patients are put on general anaesthetic so that they do not feel any pain. A small cut is made to the abdomen (stomach) so that the laparoscope can be inserted. The laparoscope is a small tube with a light source – which is used to examine the inside of the abdomen. This procedure is preferable to traditional surgery as only a small incision is made to the skin.
During an endoscopy a sample of tissue may be taken from the organs – this is called a biopsy. This sample is used for further diagnostic analysis by the Histology Department.
PATHOLOGY LABORATORIES
The Pathology Laboratories carry out essential investigations for the diagnosis and treatment of all types of cancers. During their visit to the hospital, patients may be required to have tests done when staying in the ward as an inpatient, or as an outpatient visiting the clinic. Such investigations may include, for example, blood testing or biopsies.
The laboratory services are divided into the following departments:
- Biochemistry
- Haematology
- Microbiology & Infection Control
The Biochemistry lab is full equipped with the facilities to carry out routine biochemical tests, such as functioning tests and tumor marker assays. The Consultants carry out the tests to monitor the patient’s progress and assess how the body is working. These tests are particularly important in assessing pre- and post- chemotherapy treatments, as well as pre- and post-surgical procedures. The laboratory is managed by the Consultant Chemical Pathologist – who oversees the work of the 7 medical laboratory technologists. The entire lab is fully maintained and assured to top quality.
The main types of functioning tests include liver and renal function tests, as well as urine tests:
- Liver function tests involves the measurement of serum bilirubin ALT, SLT, alkaline phosphates to monitor the function of the liver
- Renal function tests involve the measurement of serum creatinine, blood urea and electrolytes to monitor the function of the kidney
- Urine tests are used to measure the body’s uric acid, electrolytes, protein, ketone bodies etc.
These tests are carried out using several facilities, including a fully automated biochemistry analyser (Mindray BS 300), Roche AVL ion selective electrodes, and a Hycel flame photometer. Tumor marker assaying is carried out using a Chemiluminescence technique.
Quality Assurance
The entire laboratory is quality assured through an internal quality control programme as well as external programmer un by the Medical Research Institute, the Sri Lanka Accreditation Board and Aqualab- France.
The Haematology Department are responsible for carrying out laboratory investigations, including bone marrow examinations and coagulation studies. The other main responsibilities of the Department include support for patient care, training and research. The scope of work is based on diagnostic Onco-Haematology, and to assist the Clinical Oncology team of the hospital. The team includes two Consultant Haematologists, Registrars, Medical Officers, Laboratory Technicians and Assistants.
Bone Marrow Examinations
Every year 3000 bone marrow examinations are carried out including:
- Bone marrow cytology and cytochemistry
- Bone marrow Histology, immunohistochemistry and special staining tests
- Cytogenetic and molecular analysis of Bone marrow sample in collaboration with overseas laboratories
Coagulation Studies
Coagulation studies are carried out, which measure the bloods ability to clot
Patient Care
- Management of Aplastic Anaemia Patients.
- Management of general haematological diseases
- Monitoring patients on long-term anticoagulants
Training (Clinical Medical Education)
- As the main Onco-haematology centre in the country for post-graduate medical education, the Department is responsible for training clinicians.
- Provide training programmes for the Medical Laboratory technicians including foreign apprentices
Research
The Department have had significant achievements in research, including awards for their studies. Involvement includes:
- Participation in scientific forums – Sri Lanka Collage of Haematologists
- Publication of research papers
The Microbiology & Infection Control Department is found on the 2nd floor of the new laboratory complex. The Department carries out a full range of laboratory techniques on blood cells and cultures. During the patients visit to the hospital (as an inpatient) or as an outpatient, the doctors may take a blood test to be analysed by the Department of Microbiology and Infection Control. The Department are directly responsible for carrying out microbiological diagnostic procedures. The diagnostic facilities carried out by the Department include direct smear investigations, culture analysis, antibiotics sensitivity testing (ABST), and Hepatitis B detection.
In addition to the diagnostic facilities mentioned above, the Consultant Clinical Microbiologist and the medical team provide clinical advice related to the management of infectious diseases. This includes:
- Setting up infection control in the Hospital and developing a long-term strategy as well as timely and effective action for acute problems such as outbreaks
- Development of specific policies and guidelines for the implementation, surveillance and audit of infection control practices
- Arranging awareness programmes for hospital workers and ensuring the required infrastructure, personnel and funding
- Providing expert advice regarding problems related to infection control
Other activities and achievements include the research activities, which are conducted.