Advanced Endoscopy for Complex GI Conditions

All gastroenterologists use an endoscope to diagnose, treat and manage digestive disease. Sometimes, you need a more specialized procedure from a more specialized doctor.

Fellowship-trained in advanced endoscopic techniques, our endoscopists are among only a handful of gastroenterologists in Iowa with the skills and experience in these complex procedures. When you need a referral — or to refer — for expert digestive care from an advanced team, talk to our specially-trained GI doctors.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging procedure used to look into your pancreatic ducts, bile ducts and gallbladder. The endoscope goes through your mouth to the bile ducts or pancreas duct , where your endoscopist can remove biliary stones, take samples of strictures, place stents to relieve obstruction or jaundice and perform other therapies.

Bile Duct Stone Removal 

Gallbladder stones can move out of the gallbladder or the bile ducts and become lodged, causing agonizing pain and potential damage to the gallbladder, liver or pancreas. During ERCP, a small cut is made on the inside to open the bile ducts enough to remove the stones — this is called a sphincterotomy. Sometimes a balloon is used to dilate the tract to remove very large stones. Advanced endoscopists also use a special tool called SpyGlass® to look directly into these tiny ducts and facilitate therapy to fracture these stones into smaller pieces.

Endoscopic Ultrasound

Endoscopic ultrasonography (EUS) is a form of ultrasound performed inside the body instead of externally. An endoscope with an ultrasound probe on the end is inserted through either your mouth or anus to get a deeper look at problems along your gastrointestinal tract. EUS is used to diagnose pancreatic disease, gallbladder disease and blockages, and to help stage certain cancers or suspected cancers — particularly for rectal and esophageal cancer.

Fine Needle Aspiration

Fine needle aspiration, or FNA, is a type of biopsy performed during EUS on lesions just outside of the GI tract. When passed through an endoscope, a very fine needle can reach the deepest parts of your body to collect a sample of abnormal masses or bodily fluid. As with other types of biopsies, the sample is used to help diagnose cancers and other conditions in the GI tract.

Endoscopic Mucosal Resection

Endoscopic mucosal resection (EMR) is used when big nodules go deep into the tissue of the GI tract — most commonly in the treatment of Barrett’s esophagus. An advanced endoscopist completely removes, or resects, the large lesion and leaves the remaining healthy tissue. The nodule is biopsied for cancer, saving you from a bigger, more invasive operation to remove the tissue.

Radiofrequency Ablation

Radiofrequency ablation (RFA) is another endoscopic therapy used as part of the full-spectrum care for Barrett’s esophagus. Heat from radiofrequency energy burns tissue in the lining of the GI tract after a mucosal resection, prompting cells to heal and grow back as normal tissue. This advanced technology allows for endoscopists to fully remove and repair the problematic area, preventing the removal of the whole esophagus or other sections of the GI tract.

Large Polypectomy 

When colon polyps are found during your colonoscopy, they are removed for biopsy. Large colon polyps require advanced endoscopic techniques, including endoscopic mucosal resection, to remove the tissue and repair the colon. The combination of these minimally-invasive procedures helps avoid the need for a surgical operation that can leave you hospitalized for a week or more.

Drainage of Pancreatic Fluid Collection

Pancreatic fluid collections (PFCs) are a common after-effect of pancreatitis, a potentially-damaging condition. While many PFCs resolve on their own, drainage is often necessary for persistent, infected or recurring collections. Endoscopic drainage of PFCs helps alleviate symptoms of pancreatitis without undergoing surgery.

Meet Our Advanced Endoscopists

Very few gastroenterologists in Iowa have the expertise to diagnose and treat rare, complex digestive disorders. Two of them, both fellowship-trained in advanced endoscopic techniques, are found at our Endoscopy Center in West Des Moines.