Advanced Endoscopic Procedures: From Diagnosis to Minimally Invasive Treatments

SINGAPORE, May 5, 2023 /PRNewswire/ — Endoscopy has come a long way since its inception in the mid-1800’s. Various technological advancements within the realm of gastroenterology and hepatology have allowed the scope to reach deep-seated organs or examine long structures, like the intestines. “Advanced endoscopy” procedures are those which require additional training over and above general endoscopy procedures. These procedures provide a minimally invasive alternative to treating certain conditions that would have otherwise required conventional open surgery.

In this article, Dr Benjamin Yip, Consultant Gastroenterologist and Medical Director of Alpha Digestive & Liver Centre, tells us more about advanced endoscopic procedures and their potentially life-saving functions.

Endoscopic Ultrasound (EUS) 

An endoscopic ultrasound (EUS) is a minimally invasive endoscopic procedure that involves the use of an ultrasound scanning probe attached to the tip of the endoscope. It allows the gastroenterologist to examine the lining of the upper (oesophagus, stomach and duodenum) and lower (sigmoid colon and rectum) gastrointestinal tract, as well as the structures next to the GI tract such as lymph nodes, tumours, collections, the pancreas, liver, gallbladder and bile duct. 

Diagnostic purposes

EUS can be used to diagnose diseases, including:

Bile duct stonesPancreatic cystsAny form of cancer in the digestive tract (oesophagus, stomach, rectum, pancreas)Any abnormal growths in the digestive tract (stomach, oesophagus, rectum)Lymphoma and enlarged lymph nodes in the abdomen and chestTissue can also be obtained via fine-needle aspiration (biopsy) for a more detailed analysis to aid in diagnosis.

Therapeutic purposes

EUS can be used to treat certain medical conditions without the need to make a cut on the body and perform surgery. These include:

Drainage of pancreatic cystsAspiration of fluid-filled spaces in the abdomenTreating any bleeding in the digestive tract from a burst blood vesselFor treatment of pancreatic diseases, via applying nerve blocksVarious ablative therapies

In Dr Benjamin Yip’s personal opinion, the EUS is a procedure tailor-made for the pancreas, which is a deep-seated abdominal organ often obstructed by other organs and structures.

For both diagnostic and therapeutic purposes, an EUS allows the gastroenterologist to access the pancreas (given the configuration of the stomach and duodenum) in a minimally invasive manner. Otherwise, access to the pancreas would generally be performed percutaneously (via the skin), which would often not be possible due to the inaccessibility of the pancreas.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure used to look at or treat the bile ducts, pancreatic ducts and gallbladder.

During the ERCP, a thin, flexible, and hollow tube with a camera attached at one end, called an endoscope, is inserted through the mouth and carefully moved into the digestive tract. The endoscope goes from the mouth to the oesophagus, stomach, and then lastly to the duodenum, the first part of the small intestine.

Diagnostic purposes

ERCPs may be used to evaluate certain conditions:

Biliary tract abnormalitiesDilation of the bile ductBile duct obstruction (causes include gallstones)Evaluating narrowed segments, also known as strictures, of the bile ductsCancer in the liver, pancreas, or gallbladderInfections of the bile ductsPrimary sclerosing cholangitisA sample of tissue or cells may also be removed (biopsy/brushing) during the ERCP to be sent to the lab for further analysis by a pathologist

Therapeutic purposes

ERCPs may be used to treat certain conditions of the bile ducts and pancreatic ducts. It may also be used  to treat complications after gallbladder or liver surgery.

Gallstone extractionInsertion of a stent to relieve blockageDilation of stricturesEndoscopic sphincterotomy (opening up the entry of the ducts into the bowel)Drain blocked areas

Dr Benjamin Yip shares, “Although ERCP is one of the higher risk endoscopic procedures, it is usually well-tolerated. I had a patient in her 90’s with incurable ampullary cancer, in which I did ERCP and inserted a biliary metal stent to prevent biliary blockage. I remember seeing her one year after the ERCP, and she remained well, and the stent was functioning well!”

Deep Enteroscopy

Deep enteroscopy is an incisionless procedure whereby a long endoscope is inserted into the gastrointestinal tract. A common type is balloon-assisted enteroscopy, which makes use of small balloons to allow an endoscope to effectively travel through the small intestine, which is typically hard to reach. After the endoscope is inserted through the mouth (antegrade approach), the balloons are alternately inflated and deflated, allowing movement through the gastrointestinal tract. For the retrograde approach, the endoscope is inserted through the anus.

On average, the small intestine is six metres long, making it difficult to reach using more-traditional endoscopy procedures. Deep enteroscopy works by “pleating” the intestine as the endoscope is threaded through it, which can be likened to pushing a rod through a curtain.

Diagnostic

Deep enteroscopy could be used as a diagnostic tool to:

Find the cause of bleeding in the small intestineDetect and biopsy strictures (abnormal narrowings, inflammation or scar tissue)Detect and biopsy abnormal tissueDetect and biopsy polyps or tumours

Therapeutic

Deep enteroscopy serves a therapeutic purpose, and various miniature tools can be attached to the end of the endoscope to:

Stop the bleedingRemove polyps within the small intestineWiden a strictureRemove a foreign body stuck in the small intestineImplant a stent to prevent the re-narrowing of a section in the small intestine

The small bowel used to be a “no man’s land” for Gastroenterologists as they are deep within the abdomen and were difficult to reach with the instruments of the past. Nowadays, however, modern endoscopes with various capabilities allow the Gastroenterologist to access these difficult-to-reach areas — sometimes saving the patient from having to undergo surgery.

About Dr Benjamin Yip

Dr Benjamin Yip is an experienced Consultant Gastroenterologist and the Medical Director of Alpha Digestive & Liver Centre.

Dr Benjamin Yip sees patients with General Medical as well as Gastroenterology/Hepatology problems. His main interest and joy lies in endoscopy. He regularly performs general endoscopies such as gastroscopy and colonoscopy (both diagnostic and therapeutic). However, his expertise lies in Advanced Endoscopy, where he performs complex endoscopic procedures, including ERCP, EUS, deep enteroscopy, SpyglassTM cholangioscopy and enteral dilation/stenting.

Prior to his private practice, Dr Yip served in the public sector for almost two decades. He was appointed Consultant at  Khoo Teck Puat Hospital (KTPH) as well as Ng Teng Fong General Hospital (NTFGH). He is currently still a Visiting Consultant at NTFGH.

About Alpha Digestive & Liver Centre

The Alpha Digestive & Liver Clinic is led by Consultant Gastroenterologist, Dr Benjamin Yip. The term “Alpha” was inspired by the first letter of the classical Greek alphabet and the first number. Similarly, the Alpha Digestive & Liver Clinic strives to be your first point of contact for any gastrointestinal conditions, from comprehensive screening services to diagnostic tests and minimally invasive treatment procedures.

Dr Yip believes that gastrointestinal health is hugely interconnected to our whole-body health and sees patients with General Medical, as well as Gastroenterology and Hepatology problems. With that in mind, the clinic places great emphasis in caring for all aspects of your gut health — from preventative measures to personalised treatment plans with minimally invasive treatment procedures.

Alongside an experienced team, the Alpha Digestive & Liver Clinic provides gut health management advice, prompt scheduling services, diagnostic tests and treatment plans tailored to patients with all needs and concerns.

Website: www.alphagastro.sg

Facebook: www.facebook.com/alphagastro.sg

Instagram: www.instagram.com/alphagastro.sg

 

View original content to download multimedia:https://www.prnewswire.com/apac/news-releases/advanced-endoscopic-procedures-from-diagnosis-to-minimally-invasive-treatments-301815665.html

SOURCE Alpha Digestive & Liver Centre

Malaysia Healthcare Travel Council Denies Allegations of Lack Of Direction in the Company

KUALA LUMPUR, Malaysia, March 02, 2024 (GLOBE NEWSWIRE) — M

World Trade Organization Continues to Allow Subsidized Overfishing

WASHINGTON, March 01, 2024 (GLOBE NEWSWIRE) — This week, at

澳門2023年GDP增長80.5%

澳門統計暨普查局資料顯示,隨着本地經濟活動及服務出口有序復常,2023年澳門本地生產總值(GDP)錄得實質增長80.5%。

新發展 新空間 新動能——澳門各界歡迎橫琴正式封關運行

新華社澳門3月1日電 題:新發展 新空間 新動能——澳門各界歡迎橫琴正式封關運行

Veracio to Unveil their Next Generation of Orebody Technology Tools to Transform Mineral Exploration and Mining

SALT LAKE CITY, March 01, 2024 (GLOBE NEWSWIRE) —  Veracio,

Acronis Announces #TeamUp Partnership with Digacore and the New York Yankees

NEW YORK, March 01, 2024 (GLOBE NEWSWIRE) — Acronis, a glob

【特刊】二萬港元?

港府自去年10月起為每名新生兒提供二萬港元獎勵金。專家接受記者採訪時稱,此舉浪費公帑。 

“一國兩制”新實踐!橫琴正式封關運行

新華社廣州3月1日電(記者周強、王浩明)作為中國實施高水準制度型開放的重大探索,橫琴粵澳深度合作區3月1日零時正式實施封關運行,這標誌著構建與澳門一體化高水準開放新體系邁出關鍵一步,有助於豐富“一國兩制”實踐探索,更好推動澳門融入國家發展大局。

ATHA Energy Announces Approval to List on TSXV and Receipt of Final Order for Arrangement With Latitude Uranium

VANCOUVER, British Columbia, March 01, 2024 (GLOBE NEWSWIRE)

相關文章

【特刊】政府能如何更進一步?

仍然可以採取很多措施;但實際成效仍有待觀察。社會各有各說法,意見分歧。

澳門2024年GDP預計按年增一成

澳門經濟財政司司長李偉農預計2024年澳門本地生產總值(GDP)按年實質增長率可達10.3%,恢復至2019年水平約九成。

澳門1月入境旅客量恢復至疫前水平83.5%

澳門統計暨普查局資料顯示,今年1月入境旅客按年增加一倍至2,861,609人次,恢復至2019年同期83.5%。1月錄得199,278人次國際旅客,恢復至2019年同期的66.4%。

【特刊】龍年嬰兒潮:1988 年和 2012 年(2000年除外)

2000年經濟衰退期間,圍繞龍寶寶的吉祥信念並沒有成功緩解父母對生育的擔憂。

政府公佈輕軌行車系統營運36.6億元合同判給結果

澳門政府將“輕軌東線之行車系統”判予三家實體合作經營,判給金額達澳門幣36.57億元(折合約4.6 億美元)。

春節黃金周首五天近90萬旅客訪澳

春節黃金周僅五天,澳門已接待入境旅客898,665人次。週三(年初五、2月14日)勢頭十足,錄得入境旅客達195,567人次。八日春節黃金周的訪澳旅客總數有望超過旅遊局最初預估的96萬人次。