טיפולים אנדוסקופיים

Consultation with a gastroenterologist

Frontal Consultation with Dr. Idan Levy at Medical Center Herzliya

Gastroscopy Examination

Endoscopic examination aimed at diagnosing and sometimes treating various diseases of the upper gastrointestinal tract - esophagus, stomach and duodenum

Colonoscopy Examination

Endoscopic examination aimed at diagnosing and sometimes treating various diseases of the large intestine and the most terminal part of the small intestine

Endoscopic Ultrasound Test

Examination that combines ultrasound with endoscopy to provide detailed images of the walls of the gastrointestinal tract and nearby organs

Endoscopic Retrograde Cholangio Pancreatography (ERCP)

Advanced Endoscopic Procedure Combining Endoscopy and X-ray to Examine and Treat Biliary Tract and Pancreatic Problems

*Additional advanced treatments performed by Dr. Idan Levy at Sheba in the public framework only

Barrett's Mucosa

Mucous membrane in the passage between the esophagus and the stomach which most often appears as a result of many years of exposure of the esophagus mucous to the acid that rises from the stomach. This mucous is a risk factor for esophageal cancer. As part of the gastroscopy, a very precise examination of the extent and level of change in the mucosa is required, an assessment which is carried out using special optical means. Accordingly, in a gastroscopy it is possible to perform an ablation of the mucosa using radio frequencies (RFA), or if necessary the resection of pre-malignant lesions.

Complex polypectomy using the EMR method

A polyp is an overgrowth of the digestive tract's tissue which is usually considered as a pre-malignant finding. The level of risk for malignancy is determined according to the polyp's various characteristics such as its size, shape, histological characteristics ("biopsy"), overall number of polyps as well as the family history. There are several ways to perform a polypectomy, and the larger the polyp is, or when it is located in more complex locations in the colon, the more complex techniques and more extensive medical experience is required. One of the techniques is EMR which is required mostly for larger polyps, mainly over 2cm in size.

Double-Balloon Assisted Enteroscopy

An endoscopic procedure for the testing and treatment of lesions in the small intestine. A standard gastroscopy reaches only up to the second part of the duodenum, and a colonoscopy encompasses the colon and the very final part of the small intestine. Located in between them is the small intestine which is about six meters in length. In order to reach different lesions that can be seen in various imaging tests or in the small intestine capsule ("Endoscopic Capsule), enteroscopy must be performed, which is a deep small intestine endoscopy using a specific technique that requires a great skill. The test allows for the detection of lesions in the small intestine (such as a polyp, ulcer, bleeding lesions), as well as to treat them if necessary.

Fine-Needle Aspiration using EUS

Using EUS it is possible to aspirate the gallbladder in patients that are not surgical candidates for a cholecystectomy, and it is possible to aspirate bile ducts in cases of a pancreatic/bile tract tumor when ERCP is not possible. It also makes it possible to aspirate abdominal abscesses created by accute pancreatitis. These procedures are mostly carried out in hospitalized patients. These aspirations require a great deal of knowledge, experience and expertise both in ERCP techniques as well as in EUS techniques.

Connecting the stomach to the colon using EUS

In cases of obstruction of the Polyrus/head of the duodenum there are several endoscopic options. One option is to insert an expanding metal stent which is placed in the area of the obstruction thus opening the obstruction and allowing the advancement of food. Another option is surgery when a connection is made between the stomach and the small intestine. Between these two options there is a third option of making a connection between the stomach and the small intestine using the EUS method. Studies have shown that the effectiveness of surgery and an endoscopic procedure are the same, however the period of time for resuming eating and chemotherapy treatment is shorter in the endoscopic method. Furthermore, the surgery itself and its possible complications are avoided.

Alleviating abdominal pain using EUS

In cases of abdominal pain caused by a pancreatic tumor or chronic pancreatitis there is a possibility of injecting a numbing agent into the nervous system using EUS. The procedure is short and carries very few complications. Nevertheless, the effectiveness is limited and is estimated to last only for a few months, although this is also important in terms of the patients' quality of life.

Treating Gastric Varices using EUS

Gastric varices are dilated submucosal veins in the esophagus and the stomach that are usually formed on the background of liver cirrhosis. Treatment of Esophagogastic veins is done by ligation in a gastroscopy, but the treatment of gastric varices is more complicated. Bleeding from gastric varices is life threatening and therefore treating them is considered a life saving treatment. The most effective treatment is by injecting coils with a viscous substance on them which adheres to the coils. This procedure causes the flow of blood in the varices to stop and later on to disappear.

Ablation of pancreatic lesions using the RFA technique

This is an EUS guided procedure, during which there is an ablation of certain types of lesions in the pancreas, mainly hormone secreting neuroendocrine tumors.

Bile tract Cholangioscopy

Cholangioscopy is an endoscopy of the bile tract that is performed by inserting a tiny endoscope through the work canal of a standard endoscope used for ERCP into the bile tract, thus allowing the direct visualization of the bile tract. This visualization enables a precise biopsy of lesions in the bile tract for the purpose of accurate diagnosis, accurate mapping of bile tract tumors for optimal surgical planning, diagnosing complex and severe narrowing in PSC disease, and lithotripsy using an electro-hydraulic method, that cannot be crushed using a standard ERCP for various reasons.

POEM (Per Oral Endoscopic Myotomy)

This is a procedure which is part of the procedure package named "Third Cavity Endoscopies). Its primary purpose is to treat the Achalasia disease, and it is one of the possible treatments for this disease. This procedure is similar in its long-term effectiveness to the proposed Achalasia surgery (named a Heller surgery), and it is significantly more effective than a pneumatic dilation or the Botox injection, which are two alternative treatments for the disease. The procedure is complex and requires a great deal of skill.

Lesion Resection (Full thickness resection) using the FTR Method

Gastrointestinal lesion resection technique in certain indications such as small submucosal lesions.

Suturing defects/leakage/fistula of the digestive tract using the X-Tack system

This is a suturing technique which is good for closing defects in the mucosa or wall of the digestive systems, and is good for both the upper and lower digestive tracts. This procedure is performed using a standard endoscope (gastroscope/ colonoscope) with an accessory that is inserted through the work canal of the endoscope. Studies have shown that this suturing method is good mainly for the closure of mucosal defects of the digestive system (the most superficial layer) and less, although it is still good when the defect is on the entire wall.

*Subject to appointment availability at Sheba

We see patients at the following medical centers:
Herzelia Medical Center – 6 Ha'Choshlim Street, Herzelia Raphael Hospital – Atidim Park, Building No. 3, Tel Aviv