Going Beyond Standard Endoscopic Care

Our interventional endoscopy team strives to push the boundaries of endoscopic technology for the benefit of our patients. Our complex endoscopic procedures can diagnose conditions early and spare patients from major surgery. We use the most innovative endoscopic techniques to provide minimally invasive solutions. Many of the advanced techniques we use were developed or perfected by our physicians.

We collaborate with referring physicians to develop personalized treatment plans, and we keep them informed at every point in patient care. Our consultation and procedure turnaround time is fast — 24 to 36 hours.

We work with UChicago Medicine experts in a variety of specialties to provide a team approach to care. Our team also includes nurse coordinators who are dedicated to helping our patients navigate and understand their treatment, whether that is a simple, one-time procedure or requires ongoing care.

Our services include:

  • Advanced imaging techniques to identify precancerous conditions, sometimes even before they can be found with standard endoscopy
  • Endoscopic treatment of malignancies and obstruction of the GI tract and other complicated conditions, sparring patients from the risk of surgery
  • Precise endoscopic diagnosis and staging of cancer, enabling referring physicians to plan the most appropriate and effective treatment

Many of the procedures we offer are available at only a handful of hospitals nationwide. These differentiating procedures include peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), photodynamic therapy (PDT) and endoscopic sleeve gastroplasy (ESG).

Endoscopic Procedures

What is peroral endoscopic myotomy (POEM)?

Peroral endoscopic myotomy (POEM) is minimally invasive procedure that uses endoscopic technology to treat digestive and swallowing disorders. This incisionless technique offers quick recovery and treats rare digestive disorders such as achalasia, a disorder of the esophagus that makes it difficult to consume food.

During the procedure an endoscope is inserted into the mouth and moved through the throat creating a tunnel between layers of the esophagus. When the endoscope reaches the lower esophageal sphincter, an incision is made in the muscle, permanently opening the value.

UChicago Medicine is one of the few centers in Chicago and Illinois offering peroral endoscopic myotomy (POEM) to patients for the treatment of digestive and swallowing disorders.

What is endoscopic submucosal dissection (ESD)?

Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic resection technique to examine and remove growths from the lining of the GI tract. This includes Barrett's esophagus nodules, complex colon polyps and duodenal adenomas. This technique was developed as an alternative to standard surgical procedures. Due to the increased technical difficulty, ESD is only available at a few selected care centers in the United States.

Endoscopic resection is one of our team's main areas of research. We were one of the first groups in the nation to perform endoscopic mucosal resection (EMR). Our experience performing EMR spans 15 years and thousands of cases. Therefore, it is natural evolution for use to now perform ESD.

Endoscopic submucosal dissection (ESD) can be considered for:

  • Superficial esophageal cancer (both squamous or adenocarcinoma)
  • Early gastric cancer
  • Early colorectal cancer (limited to the superficial submucosa)
  • Non-lifting colorectal lesions

What is photodynamic therapy (PDT) for cholangiocarcinoma?

Cholangiocarinoma is a relatively rare cancer of the bile ducts with approximately 5,000 cases annually in the United States. For more than 80 percent of patients, the disease is unresectable. Therapy options traditionally have been limited to chemotherapy and palliative bile duct stenting to relieve jaundice.

In photodynamic therapy (PDT), the patient receives an IV porphyrin sensitizer 48 hours prior to endoscopic application of light to the tumor with the purpose of causing cell death. The light is delivered via a flexible fiber during endoscopic retrograde cholangiopancreatography (ERCP) at the time of biliary stent placement or exchange. 

Although data on the use of PDT in cholangiocarcinoma is limited, initial studies in patients with unresectable disease have suggested the treatment not only aids biliary decompression, but also improves survival through actual tumor destruction. The main side effect of this therapy is severe photosensitivity for 30 days for which the patients must be counseled.

UChicago CERT is the only center in the city to offer PDT for therapy of unresectable cholangiocarcinoma.

What is endoscopic sleeve gastroplasty (ESG)?

The endoscopic sleeve gastroplasty (ESG) is a minimally invasive, endoscopic procedure that reduces the size and volume of the stomach to aid in weight loss. The procedure is designed for patients with a body mass index (BMI) between 30 and 40 who have struggled to lose weight with diet and exercise alone. When used together with lifestyle changes, this nonsurgical weight loss procedure can help patients lose nearly 20 percent of their total body weight.

UChicago Medicine is currently the only hospital in Chicago offering this outpatient procedure.

During ESG, an endoscope is inserted through the mouth, down the esophagus and into the stomach. The physician places and tightens sutures, decreasing the size and volume of the stomach. The procedure is performed orally without requiring any abdominal incision or scars.

Advantages of the endoscopic sleeve gastroplasty procedure include:

  • Quick recovery
  • Reduced risk of complications
  • Can be repeated
Learn more about endoscopic weight loss procedures

What is aspiration therapy for weight loss?

Aspiration therapy is a nonsurgical, reversible, outpatient weight loss solution. During the procedure, a small tube is placed through the skin and into the inside of the stomach. The tube is connected to a small, discrete button that rests on the outside of the abdomen. Approximately 30 minutes after eating a meal, the patient connects a small handheld device to the button and empties the contents of the stomach. Up to 30 percent of calories are drained/diverted using this device, which results in significant sustained and durable weight loss. Patients can be expected to lose 15 to 20 percent of their total body weight at one year.

Although different from other standard approaches, aspiration therapy can provide substantial weight loss in a safe, reversible manner. It is differentiated from other bariatric procedures in that it allows an individual to eat and socialize normally and control their own weight loss journey. Furthermore, it is the only available endoscopic therapy with an FDA indication up to a BMI of 55 kg/m2.

Learn more about endoscopic weight loss procedures

What is a weight loss balloon procedure?

Weight loss balloons are soft, fluid or gas-filled devices placed into the stomach with the aid of an endoscope as part of a nonsurgical, outpatient procedure. During this procedure, the weight loss balloon, or intragastric balloon, is inserted through the mouth, down the esophagus and into the stomach. Once in the appropriate location, it is filled with fluid to achieve the approximate size of a grapefruit and released. The balloon effectively reduces the amount of food and drink eaten at a meal and increases the feeling of being full after eating small sized meals. The weight loss balloon remains in place for six to eight months to support healthy weight loss.

Designed for patients who are obese, having a body mass index (BMI) of greater than 30, treatment can help candidates lose weight without invasive surgery. The procedure takes 20 to 30 minutes, and patients are typically discharged home after two hours of recovery. With active participation in our medically supervised weight loss program, patients can expect a total body weight loss of approximately 10 to 15 percent.

Learn more about endoscopic weight loss procedures

What is gastric outlet revision?

Bariatric surgeries are effective methods for weight management and treatment of weight-related co-morbidities, but after long periods of time, patients may be prone to re-gaining weight and weight-related health problems. The weight regain may be due to a dilation of the gastric pouch, sleeve or connection site (anastomosis).

Transoral gastric outlet reduction is a minimally invasive, endoscopic procedure that repairs the gastric outlet by reducing the size of the connection site. If dilated, the stomach pouch or sleeve can also be reduced in size at the same time. During this outpatient procedure, sutures are inserted to tighten the stomach or the surgical connection site where it has stretched. This procedure supports weight loss, restores the feeling of fullness and encourages patients to eat smaller meals again. Patients who undergo transoral gastric outlet reduction or revision of their laparoscopic sleeve gastrectomy lose 25 to 35 pounds on average.

UChicago Medicine is one of the few hospitals in Chicago and the state of Illinois to routinely perform these endoscopic revision procedures.

Learn more about endoscopic weight procedures

We also have expertise in:

  • Endoscopic ultrasound (EUS) with fine needle aspiration (FNA)
  • Celiac plexus neurolysis
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Cholangioscopy
  • Photodynamic therapy (PDT) ablation of cholangiocarcinoma
  • Lithotripsy of large biliary and pancreatic duct stones
  • Ampullectomy
  • Endoscopic mucosal resection (EMR)
  • Endoscopic submucosal dissection (ESD)
  • Complex polypectomy in the colon and duodenum
  • Radiofrequency ablation (RFA) and cryotherapy
  • Pancreatic pseudocyst drainage and necrosectomy
  • Palliative stenting of GI tract and pancreaticobiliary malignancies
  • Extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones
  • Bariatric endoscopy
    • Endoscopic sleeve gastroplasty (ESG)
    • Intragastric balloon
    • Aspiration therapy with AspireAssist
    • Transoral gastric outlet reduction
  • Peroral endoscopic myotomy (POEM)
  • Zenker's diverticulotomy/ myotomy

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