Advanced Endoscopy

Advanced Endoscopy

St. Elizabeth’s Medical Center offers comprehensive treatment services to manage a wide spectrum of gastrointestinal conditions. Our advanced endoscopists use minimally invasive procedures—without incisions—to diagnose and treat many disorders of the esophagus, stomach, small bowel, gallbladder, liver, pancreas and colon.

Advanced Endoscopy

Steward Digestive Disease Center
11 Nevins Street, Suite 406
Brighton, MA 102135
617-562-5432
617-789-5049 fax

We provide accessible, comprehensive and multidisciplinary care that combines procedural skills with close collaboration from oncologists, surgeons, radiologists and other specialists as needed. Together we deliver not only technically successful procedures, but also better long-term outcomes.

What Is Advanced Endoscopy?

Advanced endoscopy refers to the use an endoscope (a long, thin tube with a camera that allows your doctor to see inside your body) with additional technology or equipment for more specialized tests or treatments. Advanced endoscopy gives the doctor a more detailed view of your digestive system. Recent medical advancements mean advanced endoscopy can now treat several conditions that used to require surgery. 

Why Choose St. Elizabeth's Medical Center?

Our fellowship trained, advanced endoscopists have a great deal of experience using the latest therapeutic endoscopy techniques (treatments performed through thin, flexible endoscope tubes) to address a range of complex conditions. This higher level of care (also called tertiary care) means patients undergo complex treatments through minimally invasive methods while experiencing fewer complications and hospitalizations.

Advanced Endoscopy Procedures

  • Balloon-assisted deep enteroscopy
  • Endoscopic ultrasound (EUS)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • ERCP with cholangioscopy
  • Endoscopic mucosal resection (EMR) of large polyps
  • Endoluminal stenting
  • Radiofrequency ablation (RFA) for Barrett’s esophagus
  • Radiofrequency ablation (RFA) for Biliary malignancy
  • EUS-guided drainage of pancreatic fluid collections
  • EUS-guided biliary drainage for failed ERCP
  • EUS-directed transgastric ERCP (EDGE) for patients with gastric bypass
  • Endoscopic suturing and fistula closure
  • Endoscopic full thickness resection (EFTR)
  • Endoscopic submucosal dissection (ESD)
  • Peroral endoscopic myotomy (POEM)

ERCP

Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube. An endoscopist will guide the scope through your mouth and throat, then down the esophagus, stomach, and the first part of the small intestine (duodenum). Next, the endoscopist will pass a tube through the scope and inject a dye. This highlights the organs on X-ray. A variety of micro-instruments are then used to diagnose and treat abnormalities of the ductal structures.

Click on link for additional information on ERCP – ERCP: A Patient's Guide - American College of Gastroenterology (gi.org)

EUS

Endoscopic ultrasound (EUS) is a minimally invasive procedure to assess diseases of the digestive (gastrointestinal) tract and other nearby organs and tissues. Endoscopic ultrasound combines the use of a thin, flexible tube (endoscope) inserted into the gastrointestinal tract and a device that uses sound waves to create images (ultrasound).

The high-frequency sound waves produce detailed images of the digestive tract and surrounding organs and tissues, including the lungs, pancreas, gall bladder, liver and lymph nodes.

EUS also allows the use of a small needle to remove fluid or tissue samples (biopsy) for examination in a lab. This procedure is called EUS-guided fine-needle aspiration or EUS-guided fine-needle biopsy.

POEM Procedure

Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic procedure that can permanently cure achalasia. Achalasia is a condition that causes the esophagus to lose its ability to squeeze food down into the stomach.  With the POEM procedure, there are no incisions on your body — the procedure is performed with a thin, flexible tube (endoscope) that goes through your mouth and into the esophagus. A doctor trained in the procedure uses a small knife at the tip of the endoscope to open the passageway so food can travel from your mouth to your stomach.

POEM is performed with general anesthesia in the Endoscopy Unit or in the operating room and is currently the most advanced treatment available for achalasia. The patient usually goes home the following day. For most patients, POEM has a short recovery time and low risk of bleeding and infection. 

ESD

Endoscopic submucosal dissection (ESD) is a minimally invasive procedure that uses a flexible, tube-like tool (endoscope) to remove precancerous and cancerous areas in the gastrointestinal (GI) tract. “Submucosal” means this procedure targets tumors located under the lining of the GI tract (mucosa). These tumors can be close to muscle tissue and can be difficult to remove completely with other methods.

Gastroenterologists (doctors specially trained to treat the GI tract) perform this procedure. Depending on where in the GI tract the tumor is located, the doctor will insert the endoscope through the mouth for upper GI tumors or through the anus for lower GI tumors. ESD is typically an outpatient procedure and most people go home the same day.

St. Elizabeth’s Medical Center is one of only a few centers in the United States performing ESD because the procedure requires a high degree of expertise and precision.

Our Team

Syed Mahmood, MD
Syed Mahmood, MD

Internal Medicine,
Gastroenterology

Sandeep Krishnan, MD
Sandeep Krishnan, MD

Internal Medicine,
Gastroenterology

Joyce Ortiz, NP
Joyce Ortiz, NP

Internal Medicine,
Gastroenterology