Endoscopic Interventions

Upper digestive system endoscopy (Esophagogastroduodenoscopy)
Colonoscopy
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous endoscopic gastrostomy (PEG) opening
Endoscopic ultrasonography (EUS)
Videocapsule endoscopy (VKE)
Double balloon enteroscopy
Manometry - pHmetry
Stomach balloon placement (intragastric balloon)

Some of our endoscopy procedures are intended to diagnose; some of them consist of therapeutic interventions.

Diagnostıc And Therapeutic Endoscopic Interventons

Polypectomy
Sclerotherapy
Spark plug and balloon dilatation in esophageal strictures
Stent implantation in colon and esophageal strictures
Esophageal band ligation
Band ligation to hemorrhoids
Injection of sclerosing substance into fundus varices
Removal of foreign bodies
Percutaneous endoscopic gastrostomy (PEG)
Argon plasma coagulation (APC)
Removal of stones from ballast by balloon and basket
Stomach balloon placement

What is esophagogastroduodenoscopy?

Upper gastrointestinal system (esophagus, stomach and duodenum) is the process of examination. This is done by an endoscopy instrument. The tool is in the form of a soft, plastic, pinky-finger, cable. It is a camera system that transmits the image of the paths to the television screen.

When is gastroscopy required?

Problems with swallowing (painful swallowing, difficulty in swallowing solid or liquid foods, nutrient removal, etc.)
Uncontrolled stomach depressions and burns
Abdominal pain (chewing or sustained pain in the middle upper part of the abdomen, open or a few hours after eating)
Red blood or vomiting during vomiting
Vomiting along with abdominal pain
Abnormalities in barium gastric graphy

How to prepare for gastroscopic examination; How is it done?

It is enough to stay hungry for 6-8 hours. During this time you can drink water or open tea. If you have rheumatic heart valve disease, 2 separate antibiotics are injected 2 hours before and 8 hours after the procedure. On the other hand, if you have any congenital bleeding or other illnesses, you should inform your doctor before the procedure.

Before starting the procedure, a spray that stops the nausea and vomiting in the throat and similar to that used by dentists, with a duration of effect of 15 minutes is applied. If the patients who are very stressed and do not have any medical problems, the patient is relieved by the vein and the patient is relieved. The procedure is not surgical intervention. Therefore, it does not require narcosis and complete sleeping.

What is colonoscopy? How is it done?

It is a method of displaying all the thick and small intestines adjacent to the large intestine by entering from the anus through a thin and bendable tube with a camera at the end. Examination of the portion of the large intestine near the anus is called sigmoidoscopy. Before the procedure, the intestines should be cleaned with the help of laxative. Colon (large intestine) is the most reliable method in the diagnosis of cancer. It also protects patients from cancer by detecting and removing pre-cancerous lesions like polyps and similar. In order to avoid colon cancer, it is recommended that the examination be performed to all people over 50 years old. Patients with colon cancer in their close relatives should undergo colonoscopy 10 years before the age of the youngest cancer patient in the family.

The majority of colon cancers develop over benign tumors called polyps. Colonoscopy at the appropriate time allows the polyps to be removed at the stage before cancer develops. In this way, patients are free of both cancer and surgery. Those receiving polyps from the large intestine should undergo follow-up colonoscopies every 1 to 3 years depending on the nature of the polyp. It is also used in the diagnosis and follow-up of non-cancerous bowel diseases such as colonoscopy, ulcerative colitis and Crohn's disease. Colonoscopy can prevent patients from surgery by providing diagnosis and treatment of large intestinal bleeding.

How to prepare for colonoscopy?

The bowels should be cleaned with the help of laxatives before the procedure.
As the preparation stage changes according to the individual, the details are explained to the patient by the specialist.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

It is used in the diagnosis and treatment of biliary tract inflammation (cholangitis), pancreatic inflammation (pancreatitis) which may cause stenosis or obstruction in biliary tract and pancreatic duct. Interference is made using a videomicoscopic device (Duodenoscope). The process is carried out in a period ranging from 20 minutes to an hour. Before the procedure, the patient is examined and the necessary tests are performed. The person to be ERCP should be hungry for at least 8 hours before the procedure. In addition, if the use of blood-diluting drugs such as Aspirin, Coumadin, they should be discontinued a week before the procedure.

The ERCP procedure is performed by lying on the patient x-ray table in the left side position. Before the procedure, the patient is sprayed with a local anesthetic spray into his throat to allow the patient to swallow the endoscope comfortably. Thus, although the patient is in sleep state during the procedure, the consciousness is open and communication can be established if necessary. Sedation is performed by mouth with a side-view endoscope. The duodenoscope allows the passage of the duodenum to the second part of the intestine and the area where the bile ducts are opened to the intestine.

EUS (Endoscopic Ultrasonography)

Ultrasonography is a method commonly used in the diagnosis of digestive system diseases in clinical practice. It is similar to X-ray with imaging and does not contain radiation.
EUS is performed by means of a mini ultrasound device which is used in digestive system endoscopy and emits sound waves at the end of the devices called endoscopes.
EUS is used in the digestive system in detailing the layers of the wall in the digestive system or in the digestive tract tumors that occur in the staging of the tumor (size and depth of the tumor, lymph node and adjacent organ metastasis, etc.) and digestive system located under the epithelial lesions are used to examine.
It is especially helpful in the evaluation of esophagus, stomach, pancreas and biliary tract and is superior to other imaging methods.
With the EUS, tissue samples can be obtained from tumors originating from the digestive tract and adjacent organs; cyst etc. formations can be emptied (Interventional EUS).

VKE (Video Capsule Endoscopy)

The digestive system is a long canal extending from the mouth to the anus. Endoscopic methods such as esophagus, stomach, duodenal bowel and large intestine can be examined. However, it is not possible to examine the middle parts consisting of 3 parts called duo, jejenum and ileum.
Capsule endoscopy, a method developed for this purpose, is a large pill size capsule with its own light source and camera.

How is VKE applied?

12 hours of hunger
Sensors are placed on the patient.
The data logger and the battery system are attached to the patient with a special belt.
The capsule is swallowed.
After 2 hours following ingestion of the capsule, the patient may begin to consume clear liquid foods. After about 4 hours you can eat a light lunch.
After 12 hours of recording, the patient or the equipment is removed and delivered to the unit.
The patient should not be heavily exercised on the day of operation and should not be applied such as MRI extraction etc.

VKE Imaging Samples

PEG (Percutaneous Endoscopic Gastrostomy) PLACEMENT
The feeding tube insertion into the stomach is called PEG. The procedure is performed during endoscopy and lasts about 20 minutes. As a general rule, PEG insertion is indicated in patients who cannot be fed for more than 3 weeks. The inserted tube is not used for up to 12 hours. However, nutrients and nutrients can be easily fed from the tube. The tube should be replaced annually.

Who should have PEG?

Oncologic disorders;
In tumors of the ear, nose and throat
In tumors of the upper gastrointestinal tract
In non-operable cases palliative
In neurological disorders;
Cerebrovascular stroke
Brain tumors
Bulber paralysis
Parkinson's disease
Cerebral palsy
It can be worn in patients with end-stage Alzheimer's disease who cannot eat food.

It is a process that makes life quite easier for both the patient and the caregiver. The effect of sedation to be performed before the procedure lasts for 3-4 hours, so patients should not drive. For this reason, they are advised to come to their appointments with someone who will take them back home.

Stomach Balloon Placement

Endoscopically placed, endoscopically removed.
Endoscopically placed balloon into the stomach is filled with 500-700 ml of saline.
It helps the fat person to lose weight by decreasing food intake and diet.
Stays in stays for 6 months. Should not be left for more than 6 months.
It must be performed by gastroenterologists who have experience of endoscopy and the patient should be followed carefully.

Who can stomach balloon be applied to?

It provides maximum benefit to the patient significantly reducing the risks of obesity related diseases (Type 2 diabetes, vascular diseases, joint diseases etc.).
It helps to reduce the surgical risks with preoperative weakening of obese patients who will be operated for any reason.
Within 6 months, the fat person will lose a minimum weight of around 20-25%.
It is an important condition for the success of the treatment if the patients to be administered are compatible individuals with good expectations.