What is an endoscope?

An endoscope is a thin, flexible tube that has a tiny camera and light at the end of it. It gives the doctor access to your digestive tract using existing body openings.

A routine procedure using an endoscope for initial screening or diagnosis is called an endoscopy. It can detect issues anywhere between the mouth or esophagus through the large intestine.

What is advanced endoscopy?

Advanced endoscopy is the term used when doctors use an endoscope with additional technology or equipment for more specialized tests or treatments. Advanced endoscopy gives the doctor a more detailed view of your digestive tissues. It eliminates the need for traditional surgery or large incisions.

Conditions that may benefit from an advanced endoscopy procedure

Even complex conditions that used to require a major operation and prolonged hospital stay can now be treated using advanced endoscopy. Useful for diagnosis as well as disease management, treatment or cure, advanced endoscopy can be used specifically for:

• Collecting tissue for biopsy within the gastrointestinal (GI) tract and from organs surrounding the GI tract, such as the pancreas or the liver
• Removing bile or pancreas duct stones
• Creating wider openings within the digestive tract using dilating balloons
• Placing plastic or metal stents to fix a blockage within the GI tract or pancreas and biliary trees
• Draining fluid or infections surrounding the GI tract
• Removing polyps or growths and repairing damaged tissue or fistula
• Treating bariatric surgery complications or implanting new devices that promote weight loss

Benefits of advanced endoscopy

Advanced endoscopy makes it possible to get a very detailed view of affected organs, accurately collect samples for diagnosis and deliver very focused treatments, even in small, hard-to-reach areas.

Because a large, open incision is not necessary, blood loss is minimized or eliminated, the risk of infection is reduced and recovery time is much quicker. Usually done as an outpatient procedure, advanced endoscopy is also more convenient for patients.

Why choose Ohio State?

Advanced endoscopy can be technically challenging and requires additional training. Ohio State’s advanced endoscopy specialists have the experience needed to perform these techniques and interpret the results. They are also active in research related to advanced endoscopy, so you know you are receiving the latest treatment available.

From check-in through recovery, you’ll be cared for by an entire team that routinely performs advanced endoscopy procedures with state-of-the art equipment.

Types of advanced endoscopy

Below are some of the advanced endoscopy techniques performed at Ohio State for diagnosing or treating gastrointestinal (GI) or biliary disorders:

• Endoscopic ultrasound (EUS): an endoscope that uses high-frequency sound waves to produce detailed images of the GI tract
• Endoscopic retrograde cholangiopancreatography (ERCP): an endoscope and X-ray are used together; the patient is given a dye to enhance the images
• ERCP with cholangioscopy: an endoscope along with X-ray and additional technology that provides very detailed visualization; used primarily for treatment of bile duct stones and evaluation of narrow ducts
• Confocal laser endomicroscopy (CLE): an endoscope procedure that magnifies and creates very high-resolution images; tissue is illuminated with a low-power laser and use of fluorescent light
• Balloon-assisted deep enteroscopy: an endoscope with a small balloon that can inflate or deflate allows the doctor to see and treat less accessible parts of the gastrointestinal (GI) tract. This is especially useful because the GI tract can have many folds and crevices
• Endoscopic mucosal resection (EMR) of large polyps: an endoscope is used to remove early-stage cancer or precancerous growths from the lining of the GI tract
• Endoluminal stenting: a self-expanding wire mesh tube is placed within the GI-tract using an endoscope to remove bowel obstructions
• Radiofrequency ablation (RFA) for Barrett’s esophagus: an endoscope is used to deliver very targeted heat to essentially burn off or eliminate precancerous tissue from the esophagus
• EUS-guided drainage of pancreatic fluid collections: an endoscope with ultrasound is used to pinpoint and drain collections of pancreatic fluid, a common complication of acute pancreatitis
• EUS-guided biliary drainage for failed ERCP: ultrasound used with an endoscope allows the detail necessary to clear stones or blockages for effective drainage of bile into the liver
• EUS-directed transgastric ERCP (EDGE) for patients with gastric bypass: an endoscope is used to temporarily reverse a gastric bypass while stones or blockages are removed. The stent is then taken out and the bypass restored
• Endoscopic sleeve gastroplasty: an endoscope is used to reduce the size of the stomach and place sutures
• Endoscopic suturing and fistula closure: an endoscope is used to allow minimally invasive suturing of a stent to keep it in place or to repair any holes or openings (fistula) in the GI tract
• Endoscopic full thickness resection (EFTR): an outpatient procedure that uses an endoscope to remove growths deep within the walls of the GI tract and repair the tissue following removal
• Endoscopic submucosal dissection (ESD): a minimally invasive procedure using an endoscope to remove cancer that has not entered the muscle layer of the GI tract
• Peroral endoscopic myotomy (POEM): for treatment of swallowing disorders; an endoscope is used to improve the passage of food and liquids into the stomach
• Transoral incisionless fundoplication (TIF): an endoscopic procedure that wraps the upper portion of the stomach around the esophagus to improve symptoms of gastroesophageal reflux disease (GERD)

What to expect during your advanced endoscopy procedure

• Patients typically do not need an overnight stay.
• To prepare for the procedure, you may need to fast or take a laxative in advance. You’ll also be asked to stop taking aspirin or any blood thinners. Your doctor will provide detailed instructions before your visit.
• You’ll be given a sedative by an anesthesia specialist to keep you comfortable during the procedure, which should last about an hour.
• When you’re done, you’ll be cared for until the sedative wears off. You’ll need someone to drive you home, and you should schedule the rest of the day off from work or activities.
• Some patients experience mild soreness or bloating, but this resolves quickly.
• There are typically no other restrictions during recovery, other than a modified diet for some patients with specific conditions. If you do have any restrictions, this will be explained and given to you in writing before you leave, along with a list of any unexpected symptoms that should prompt a call to the doctor.