The Interventional Endoscopy Service (IES) at California Pacific Medical Center offers the following areas of endoscopic expertise:

• Capsule Endoscopy
• Diagnostic and Interventional Endoscopic Ultrasonography
• Bilio-pancreatic Endoscopy
• Treatment of Bleeding (Hemostasis)
• Early Cancer Detection and Treatment (Mucosectomy)
• Endoscopic Anti-reflux Techniques

Capsule Endoscopy

With the use of a wireless swallowable video capsule we are able to perform painless endoscopic imaging of the small intestine. The capsule is only 11mm by 30mm (about the length of a nickel) packs a camera, light source, radio transmitter and batteries. Requiring no hospitalization, the patient simply swallows the capsule and the camera takes and transmits about two images per second. The video images are transmitted to aerials taped to the body and stored on a device about the size of a personal CD player worn by the patient on a belt. At the end of approximately 7-hours the patient returns to the lab and returns the recording device. An evaluation of the video images is completed to assist in diagnosing GI conditions and diseases such as bleeds, ulcerations, lesions, tumors of the small bowel, inflammatory bowel disease, Crohn's Disease, ulcerative colitis and irritable bowel syndrome. The single use capsule is eliminated through a bowel movement.

• Capsule Endoscopy in our Procedure Profile (pdf)

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Diagnostic and Interventional Endoscopic Ultrasonography

Using a tiny ultrasound transducer incorporated at the endoscope tip, endoscopic ultrasonography (EUS) enables the endoscopist to see into the bowel wall and surrounding organs, such as the pancreas and bile duct, with high spatial resolution. EUS is used to stage gastrointestinal and pancreatic cancers and to diagnose diseases of the bile duct and pancreas. A spectrum of interventional applications such as fine-needle aspiration, celiac ganglion blockade, and pseudocyst drainage are routinely performed.
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Bilio-pancreatic Endoscopy

Complex interventions in the biliary and pancreatic ducts relating to the management of stone disease, benign or malignant strictures, and sphincter of Oddi dysfunction are performed. Endoscopy of the bile duct (cholangioscopy) and pancreatic duct (pancreatoscopy) are used in selected cases for diagnosis and therapy.

• Endosonography-guided Psudocyst Drainage Procedure Profile (pdf)

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Treatment of Bleeding (Hemostasis)

A spectrum of hemostatic techniques are used to arrest bleeding from varices and non-variceal lesions (ulcers, arteriovenous malformations, vascular ectasias, diverticula, tears). Novel hemostatic techniques include hemoclipping, endolooping, and argon plasma coagulation.

• Endoscopic Cyanoacryate Glue for Gastric Varcies Procedure Profile (pdf)

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Early Cancer Detection and Treatment (Mucosectomy)

Special "zoom" magnification endoscopes are used in conjunction with chromoendoscopy (dye staining) to improve detection of pre-malignant and early malignant lesions in the upper and lower gastrointestinal tract. In suitable candidates, mucosectomy is performed to curatively treat cancers of the esophagus, stomach and colon as well as high risk "Barrett's esophagus," a premalignant condition caused by chronic gastroesophageal reflux disease.

• Endoscopic Mucosectomy Procedure Profile (pdf)

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Endoscopic Anti-reflux Techniques

A novel endoscopic treatment (Gatekeeper reflux-repair system) is used for the treatment of chronic gastroesophageal reflux disease. The treatment is FDA approved. We are evaluating this treatment in the context of an investigative protocol.

• Treatment Options for GERD Procedure Profile (pdf)

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