Advanced Endoscopy

An endoscopy is a minimally invasive procedure that allows gastroenterologists to look at the digestive tract using an endoscope – a thin, flexible tube with a camera at the end.

The board-certified, fellowship-trained gastroenterologists have additional training (beyond that of a general gastroenterologist) and can perform advanced/interventional endoscopy procedures, outside the scope of a normal endoscopy. Their expertise – combined with the latest technology and devices – ensures that all GI abnormalities are detected, even those that a regular endoscopy may miss. These advanced endoscopy procedures are used to not only diagnose but treat a range of digestive conditions such as GERD, cancers affecting the GI tract, gallstones, ulcers, anal fistulas and more.

With these procedures, our patients can avoid surgery, recover quickly and experience no scarring or other complications. Some of the advanced endoscopy procedures we offer include:

• Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts and pancreas. It involves inserting a tiny, flexible lighted tube into the pancreas and injecting dyes that can be seen on X-rays. ERCP can be used to treat conditions that would otherwise be treatable only with surgery. It also can aid in diagnosing pancreatic cancer.
• Endoscopic ultrasound (EUS): EUS is a minimally invasive imaging technique that uses sound waves to create a computer image of the inside of the esophagus and stomach. The endoscope is guided into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this allows the physician to view the inside of this area of the body, as well as insert instruments to remove a sample of tissue (biopsy).
  • Tumor Staging: EUS is effective at visualizing the individual layers of the GI tract, which aids in the detection of precancerous lesions and early-stage cancerous lesions of the esophagus, stomach and rectum. EUS can be used to help physicians determine if cancer has spread to nearby lymph nodes and organs.
• Pancreatic Cystgastrostomy and Necrosectomy: Pancreatic pseudocysts are collections of leaked pancreatic fluids. They can form next to the pancreas with pancreatitis. A Cystogastrostomy is a procedure that creates an opening between a pancreatic pseudocyst and the stomach, when the cyst is in a suitable position then it drains into the stomach.
  • Pancreatic necrosis is a serious complication of pancreatitis which can be fatal, particularly if the pancreas becomes infected. A necrosectomy uses an endoscope through the mouth to wash out and remove the dead tissue.
• Pancreatoscopy: The direct visual evaluation of the pancreatic ducts. 
• Endoscopic Mucosal Resection (EMR) and Ablation: An EMR is a procedure to remove pre-cancerous, early-stage cancer or other abnormal tissues (lesions) from the digestive tract by passing an endoscope down the throat to reach an abnormality in the esophagus, stomach or upper part of the small intestine. EMR is also used to collect tissues for cancer diagnosis. If cancer is present, EMR can help determine if the cancer has spread to the tissues beneath the digestive tract lining.
  • Endoscopic mucosal ablation is a minimally invasive procedure that allows the limited removal of small nodules.
• Endoscopic Fistula Closure: This is a minimally invasive technique to repair fistulas (holes or openings between organs or tissues). If not mended, these abnormal passageways can allow fluid to leak from one body cavity to another. This fluid leakage can result in pain, infection, organ damage and even death.
• Balloon-Assisted (“deep”) Enteroscopy: This is an incisionless procedure performed to reach and treat less-accessible colon polyps or areas of bleeding in the GI tract. Balloon-assisted enteroscopy uses endoscopes equipped with balloons that inflate and deflate to pinch together the walls of the GI tract. By compressing the walls, the gastroenterologist can reach and treat less accessible areas.
• Luminal stenting: Obstruction of the GI tract causes intolerable symptoms like nausea, vomiting and severe abdominal pain, which may become life-threatening. These situations can occur when tumors obstruct these areas. The placement of stents through endoscopy relieves the obstruction by holding open the area of the GI tract that was previously blocked. A stent is a hollow tube made up of a fine, flexible wire, which is tacked into a mesh that looks like a chain-link fence. The stent is coiled up into a size similar to a thin pencil.