SURGICAL ENDOSCOPY

In surgical endoscopy, we diagnose and treat diseases of the digestive tract, the bile ducts and pancreas, and the airways.

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We offer the entire spectrum of modern diagnostic and therapeutic (interventional) endoscopy. This spectrum ranges from preventive examinations (colonoscopy and/or gastroscopy) to complex endoscopic procedures on the bile ducts or endoscopic surgery on suitable tumors in the gastrointestinal tract. Routine examinations such as gastroscopy or colonoscopy are performed under sedation as standard, i.e., with a “sleeping injection,” while (therapeutic) interventions are usually performed under general anesthesia.

In addition, our surgical endoscopy department also houses state-of-the-art functional diagnostics equipment for the gastrointestinal tract. Among other things, patients with reflux symptoms (“heartburn”) are examined here in addition to gastroscopy in order to develop a treatment plan tailored to the individual patient. Surgical endoscopy in Innsbruck has a long tradition, with ERCP having been introduced here as early as the 1970s. We offer the following endoscopic procedures:

• Esophagogastroduodenoscopy (or gastroscopy) to examine the esophagus, stomach, duodenum, and upper small intestine
• Colonoscopy (examination of the large intestine) to examine the entire large intestine and the end of the small intestine
• Rectoscopy (examination of the rectum) for the lowermost part of the large intestine (rectum)
• Enteroscopy (examination of the small intestine) to examine large parts of the small intestine
• ERCP (abbreviation for endoscopic retrograde cholangiopancreatography), primarily for the treatment of diseases of the bile ducts and pancreas
• Cholangioscopy: endoscopic inspection of the bile ducts using a special endoscope as part of ERCP
• Tracheo-bronchoscopy to examine the airways
• Endosonography:
  – Diagnostic endosonography for further examination of changes using ultrasound directly from inside the digestive tract
  – Therapeutic endosonography, for example, to treat cystic changes in the pancreas

Helicobacter pylori is diagnosed using breath tests, histological and microbiological examinations, including resistance testing.

Manometry (esophageal manometry, antroduodenal manometry) is performed to diagnose functional disorders of motility in the esophagus, stomach, and rectum. In addition, impedance measurement is performed in the esophagus, as well as 24-hour pH monitoring for acid reflux and Bili-tec testing for bile reflux.

Overview of interventional endoscopy

Objective: Treatment of diseases of the digestive tract, bile ducts, pancreas, and airways using endoscopic, minimally invasive techniques.  Examples include:

• Hemostasis through the injection of various substances (e.g., adhesives such as fibrin) or through the application of clips, rubber bands (banding), endoligatures, or coagulation using argon beamers
• Polypektomy to remove benign growths, primarily for tumor prevention
• Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD): to remove suitable tumorous changes
• Removal of foreign bodies that have been swallowed or inserted
• PEG und PEJ (percutaneous endoscopic gastrostomy and jejunostomy) for feeding patients with swallowing disorders and those fed via the stomach, and for administering medication beyond the stomach or in severe forms of Parkinson’s disease (JET-PEG)
• Bougienage and dilation to widen benign and malignant strictures
• Stent implantation to bridge pathological benign and malignant strictures
• Argon beamer application for the treatment of bleeding and malignant strictures
• Radiofrequency ablation for certain forms of Barrett’s esophagus and radiation proctitis
• Endoscopic necrosectomy for severe forms of pancreatitis
• Interventional ERCP for the treatment of numerous diseases of the bile duct and pancreas.
• Endo-vacuum therapy for the treatment of leaks in the upper and lower digestive tract.

Gastroscopy/colonoscopy (stomach/intestinal examination)

Beyond the most common issues, such as endoscopic examination of gastrointestinal complaints, the entire range of diagnostics and therapy is covered, from preventive examinations to endoscopic removal of suitable tumors..

ERCP (Endoscopic Retrograde Cholangiopancreatography)

At our clinic, biliary tract and pancreatic diseases are primarily diagnosed using a gentle radiological method known as magnetic resonance imaging. In addition to removing stones in the bile ducts, which is the most common condition, stents can be inserted to treat various narrowings of the bile ducts. Cholangioscopy allows for endoscopic assessment of the bile ducts.

Endosonography

This is both a diagnostic and therapeutic form of endoscopy. It involves performing an ultrasound examination of various internal organs (usually) from the stomach or colon, including the option of taking tissue samples for histological examination. This method also enables the minimally invasive treatment of various complex clinical pictures.

Special endoscopic procedures

Enteroscopy is primarily used to diagnose various diseases of the small intestine. Bronchoscopy allows endoscopic access to the trachea and bronchial system and, if necessary, therapeutic interventions can also be performed.