Endoscopic surgery

What is endoscopy?

Endoscopy is a safe, nonsurgical procedure used to examine a person’s digestive tract from the inside. Your doctor uses a long flexible tube, called an endoscope, that has a light and a camera attached to it. By sliding it down your throat, your doctor can get a close-up look inside your esophagus, stomach, and the upper part of your small intestine.

Sometimes, an endoscopic ultrasound is performed. This is a long, flexible tube with a light, camera, and ultrasound transducer (probe) attached to it. The ultrasound uses sound waves to create detailed images, which your doctor can view on a monitor. The ultrasound allows us to see lesions that aren’t visible to the naked eye with a regular endoscopy and can also help us examine organs outside the digestive tract.

In addition to examining the structures, your doctor can also pass thin devices through the endoscope that allow for taking tissue samples, removing polyps, or administering other treatments.

When is endoscopy or an endoscopic ultrasound performed?

  • To evaluate symptoms related to the digestive tract

  • To detect tumors in the gastrointestinal (GI) tract

  • To biopsy tumors in the GI tract. This is when the doctor removes a tissue sample from a suspicious mass and sends it to a pathology lab for analysis and diagnosis

  • To stage tumors in the GI tract, which is when the doctor determines the extent of the spread of the cancerous tumor (Stages I, II, III, or IV)

  • To assess esophageal, gastric, pancreatic, and rectal cancers

  • To detect common bile duct stones

  • To aspirate fluid cysts in the GI tract

  • To treat cysts and other GI pathologies

  • To place markers for radiation therapy

What to expect

Before the procedure

  • Inform your doctor about any allergies, health issues, or medications you take. If your doctor will also be performing fine needle aspiration, you will be checked for proper blood clotting.

  • Your stomach needs to be empty. You cannot eat or drink anything after midnight prior to the procedure.

  • You will be sedated. Plan to have someone there to drive you home after the procedure. You will not be able to return to work for 24 hours.

  • The procedure may be performed in an outpatient facility, so you can return home the same day.

During the procedure

  • You receive an IV, which is used to give you sedatives as well as other medications and fluids.

  • Your doctor uses the endoscope, often with an ultrasound probe attached, and observes the inside of your GI tract. The images are shown on a nearby monitor.

  • Fine needle aspiration/biopsy is performed if necessary.

  • The procedure lasts between 30 and 90 minutes.

  • Once the procedure is finished and the effects of the anesthesia have worn off, your doctor discusses the findings with you.

  • You are able to go home, where you should rest for the remainder of the day.

Types of services

Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP is a highly specialized technique that combines endoscopy with contrast dye to examine the pancreas, bile duct, liver, gallbladder, and the network of ducts that carry digestive fluids.

In addition to its diagnostic importance, ERCP also can be used to treat certain conditions immediately. These treatments require the experience of experts because ERCP is a highly specialized procedure. If a blockage is found in any of the ducts during an ERCP, your doctor may be able to use one of the following tools to remove or relieve the obstruction:

  • Sphincterotomy, in which your doctor cuts the muscle sphincter of the bile or pancreatic duct to remove stones.

  • Duct dilation and stenting, in which your doctor uses a balloon catheter to stretch a narrowed opening. MedStar Health experts use endoscopes to place stents in the esophagus, duodenum, and colon that help by propping open areas blocked by tumors or other obstructions.

  • Cholangioscopy, in which a smaller scope is used to examine the bile duct and pancreatic duct and deliver treatments.

  • Biliary lithotripsy, which allows your doctor to destroy gallstones trapped in your bile ducts.

Using ultrasound as a guide, your doctor sometimes will perform a fine needle aspiration/biopsy (FNA/FBA). When this happens, your doctor threads a thin needle down the scope into an enlarged lymph node or a suspicious mass. The needle then removes tissue from the sites, and your doctor sends the sample to a pathologist for diagnosis.

Endoscopic ultrasound (EUS) with FNA/FBA is a more complicated procedure than EUS alone and requires an experienced specialist for the best results.

Interventional endoscopic ultrasound

This is used to treat pancreatic disease in various ways, including:

  • Pancreatic cyst drainage/Axios stent placement

  • Placement of fiducials (small metal guides placed in and around tumors for radiation therapy)

  • Pancreatic necrosis debridement

  • Argon Plasma Coagulation (APC) is an advanced approach that uses an endoscope to deliver a burst of heat to a lesion. It can treat tumors in the stomach, esophagus, or intestine and is a faster, simpler alternative to other laser treatments.

  • Endoscopic Mucosal Resection is used to treat and remove pre-cancer lesions or early cancer in the gastrointestinal tract.

  • Cryoablation is an advanced approach that uses liquid nitrogen to deliver extreme cold energy to treat tumors in the esophagus, stomach, or intestine.

  • Radiofrequency ablation (RFA) is an advanced approach to treat pre-cancer lesions in the esophagus such as Barrett's esophagus to prevent esophageal cancer.

Intra-luminal stenting

This procedure is used to treat cancers of the esophagus, stomach, small intestine, and colon. It involves placement of different types and sizes of stents that are used for various sites within the gastrointestinal tract.

Enteroscopy (for small bowel)

The small intestine is roughly 25 feet long. Examining it requires specialized techniques and long instruments known as enteroscopes.

An enteroscopy allows your doctor to visualize the entire length of the small intestine using balloon and double balloon technology. This procedure can help your doctor identify the cause of unexplained gastrointestinal bleeding, small bowel tumors, and other possible conditions.

Wireless capsule endoscopy (pill camera)

For this procedure, a patient swallows a multivitamin-sized capsule that contains a camera, a light, batteries, and a transmitter. The capsule passes through the small intestine via the same muscle contractions that carry food, snapping two photos per second and transmitting them to a pager-sized receiver worn around the waist.

This technology at MedStar Health allows your doctor to see the entire length of the gastrointestinal tract that cannot be visualized using the traditional approach.

Our providers

Gastroenterology specialist performing endoscopic ultrasound

Expert endoscopy care

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