Endoscopy

We perform a large spectrum of diagnostic and therapeutic methods of digestive endoscopy.

Emergency endoscopic procedures are performed 24 hours a day, 365 days a year by telephone by a doctor and an endoscopic nurse with a travel time of up to 2 hours.


Performance

Oesophago-gastro-duodenoscopy (gastroscopy, GFS)

Gastroscopy is used to diagnose diseases of the upper digestive tract, including the esophagus, stomach and duodenum, and therapeutic procedures, including:

  • construction of non-variceal and variceal bleeding - ligation and sclerotization of esophageal varices in the upper gastrointestinal tract,
  • endoscopic polypectomy, 
  • endoscopic mucosal resection (mucosectomy), 
  • endoscopic submucosal dissection of early gastric, duodenal and colonic carcinomas 
  • dilatation of stenoses, 
  • implantation of esophageal, duodenal and colonic stents 
  • extraction of foreign bodies, 
  • insertion of nasojejunal probes, 
  • percutaneous endoscopic gastrostomy.

Examination information and preparation:

  • fasting (4 hours not to drink, 8 hours not to eat), 
  • introduction of medications affecting blood clotting (Eliquis, Xarelto...) according to the prescribing physician's instructions (prior to the therapeutic procedure), 
  • examination is performed under analgosedation, 
  • informed consent here (GFS, analgosedation) - after the examination, do not eat or drink for 2 hours, 
  • after analgosedation, the patient is observed for about 2 hours in the recovery room and cannot perform activities requiring increased attention, including driving for the rest of the day.

Colonoscopy (KSK)

Colonoscopy is used to diagnose diseases of the lower digestive tract, including the rectum, colon and terminal ileum, and therapeutic procedures, including: 

  • endoscopic polyp removal (polypectomy), 
  • endoscopic mucosal resection (mucosectomy), 
  • endoscopic submucosal dissection of early colon cancer (ESD), 
  • balloon dilatation of stenoses, 
  • implantation of colonic and rectal stents in malignant stenoses, 
  • EFTR-endoscopic endoscopic full-wall resection.

Examination information and preparation:

  • discontinuation of drugs affecting blood clotting (Eliquis, Xarelto...) according to the prescribing physician's instructions (prior to therapeutic procedure) is required, 
  • blood count and blood clotting results max. 14 days old, 
  • dietary measures - 5 days of omission of indigestible residues (non-protein diet), 7 days to discontinue preparations containing iron, 
  • preparation for colonoscopy - the intestine must be carefully emptied, the quality of emptying depends on the predictive power of the examination, 
  •  the examination is carried out under analgosedation,
  •  informed consent here (KSK, analgosedation) - after the examination, do not eat or drink for 2 hours,
  •  after analgosedation, the patient is observed for about 2 hours in the adolescent room and cannot perform activities requiring increased attention, including driving for the rest of the day.

Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP is used for imaging and diagnosis of diseases of the biliary tract and pancreatic ducts and the therapeutic procedures to which they belong: 

  • papillosphincterotomy (EPT) 
  • extraction of bile duct concrements, 
  • mechanical lithotripsy of concrements, electrohydraulic lithotripsy - EHL 
  • nasobiliary drainage, 
  • deployment of a wide range of stents (metallic, plastic, biodegradable) in benign and malignant biliary stenosis and pancreatic disease, 
  • endoscopic treatment of tumors of the papilla Vater, 
  • radiofrequency ablation of malignant stenosis, 
  • cholangioscopy together with intraductal ultrasonography (IDUS). 

Examination information and preparation: 

  • discontinuation of medications affecting blood clotting (Eliquis, Xarelto...) according to the prescribing physician's instructions (prior to therapeutic procedure) is required,
  • blood count and clotting results max. 14 days old, 
  • examination is performed under analgosedation, 
  • informed consent here (ERCP, analgosedation),
  • after the examination, do not eat or drink for 2 hours - after analgosedation the patient is observed for about 2 hours in the recovery room and cannot perform activities requiring increased attention, including driving, for the rest of the day.

Endoscopic ultrasonography (EUS)

EUS is used to locally assess diseases of the upper and lower gastrointestinal tract, pancreas and biliary tract using an endoscope with ultrasound. In addition, therapeutic procedures, which include: 

  • biological material collection - fine needle aspiration biopsy (FNA, FNAB), 
  • drainage of fluid peripancreatic and intrapancreatic collections, 
  • therapy of circumscribed necrosis using LAMS (hot axios), 
  • endosonographically guided conjunctival procedures:
    • gastroenteroanastomosis, 
    • dudoenoenocholedochoanastomosis, 
    • gastrohepaticoanastomosis. 

 

Examination and preparation information:

  • no drinking for 4 hours and no eating for 8 hours, 
  • discontinuation of medications affecting blood clotting (Eliquis, Xarelto...) as instructed by the prescribing physician is required prior to therapeutic procedures,
  • take blood count and clotting results max. 14 days old, internal preoperative examination (if applicable), blood and blood counts (if applicable). general anaesthesia),
  • examination is performed under analgosedation or general anaesthesia,
  • informed consent here (EUS, analgosedation) - after the examination, do not eat or drink for 2 hours,
  • after analgosedation, the patient is observed for about 2 hours in the recovery room and the rest of the day cannot perform activities requiring increased attention, including driving, or, and especially after general anaesthesia, short-term hospitalization.

Hybrid laparoscopic-endoscopic therapy (NEWS, CLEAN-NET)

Hybrid laparoscopic-endoscopic methods allowing block "covered" full-wall resection of the stomach/intestine wall. 
These methods have been developed to minimize possible contamination of the abdominal cavity by tumor cells. The methods are indicated in the case of submucosal GIT tumors, Tis - T1 GIT tumors unresectable by EMR/ESD.

Intraoperative cholangioscopy

Cholangiocarcinoma is a relatively rare, highly fatal neoplasm arising from the biliary epithelium. Radical surgery is the only treatment option. 
The aim of intraoperative cholangioscopy (SpyGlass) is to assess the intraductal limit of spread of cholangiocarcinoma and thus to assess the resectability of the tumor.