Interventional Endoscopy

Interventional endoscopy allows your doctor to perform minimally invasive surgical procedures through a scope to treat a variety of diseases. By using a scope to enter the body and work directly on digestive organs, we offer you a nonsurgical treatment option with very low complication rates. In addition, your recovery time is faster than with open surgery, because there are no incisions. Endoscopic procedures allow you to return to normal activities almost immediately.

Our highly trained doctors perform hundreds of interventional endoscopy procedures each year for digestive tract problems. We use the most rigorous safety and quality measures to achieve positive results for you. The interventional endoscopists at El Camino Health work closely with highly trained laparoscopic surgeons, surgical oncologists and interventional radiologists to provide you with comprehensive care.

In all cases, our digestive health doctors and staff recognize that your medical problem may be causing embarrassment or disruption in your life. We create a warm and friendly atmosphere to put you at ease and work together to do everything possible to find solutions that improve your quality of life.

El Camino Health’s digestive health experts have an excellent reputation for performing the following interventional endoscopy procedures:

• Double-balloon enteroscopy
• Endoscopic mucosal resection
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Endoscopic stenting
• Endoscopic ultrasound
• Radiofrequency ablation for Barrett’s esophagus
• Secca® procedure for bowel incontinence

For more information about endoscopy or bronchoscopy or if you're having a procedure and what to expect during an exam, read our frequently asked questions about endoscopy.

Double-Balloon Enteroscopy (DBE)

Double-balloon enteroscopy is a complex, highly specialized endoscopic technique your doctor can use to examine, diagnose and treat problems in your small intestine. Mountain View Hospital (El Camino Hospital) is the first community hospital in the Bay Area to offer this procedure, and we perform more than a 100 double-balloon enteroscopies each year.

For the last decade, DBE has been successfully used to evaluate and manage gastrointestinal bleeding, abdominal pain, chronic diarrhea, tumors and other small bowel disorders.

Your doctor can insert instruments through the scope to:

• Obtain tissue samples for biopsy.
• Place a stent for treatment of a blockage related to a tumor.
• Instill air or fluid.
• Give injections or stop bleeding.

Endoscopic Mucosal Resection (EMR)

Endoscopic mucosal resection is an alternative to surgery for removing tumors in certain layers of intestinal tract lining.

The doctors at El Camino Health use EMR to treat early esophageal, stomach and colon cancers. They also treat precancerous tissue of Barrett’s esophagus and use EMR to remove large colon polyps during colonoscopy.

Our EMR experts are able to successfully remove larger polyps using specialized tools and techniques, avoiding the need for surgical procedures.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a minimally invasive procedure in which your doctor is able to examine the bile and/or pancreatic ducts. If a problem is found, your doctor can often perform a procedure to repair or improve the condition. As a result, ERCP has replaced surgery for most patients with common bile duct and pancreatic disease.

Our interventional endoscopy experts at El Camino Health are regional experts in ERCP, known for their proficiency in conducting and interpreting this test. They perform hundreds of tests each year, with rigorous quality standards that meet or exceed national benchmarks.

Your doctor can insert instruments through the scope to:

• Obtain tissue samples for biopsy.
• Remove tumors.
• Ablate (destroy with heat energy) precancerous tumors.
• Implant markers into tumors for precise delivery of radiation therapy.
• Relieve obstructions. 
• Stretch ducts.
• Implant or remove stents.

Endoscopic Stenting

You’ll benefit from the superior training of our doctors at El Camino Health, who have high success rates in placing stents with minimal complications.

We use stents if you have an obstruction or narrowing in your digestive tract due to a tumor or other condition. Our doctors at El Camino Health can place stents to reinforce and hold open passageways in your esophagus, colon, small intestine and bile ducts.

A stent is a small tube, similar to a tiny straw, which we can place in a hollow structure in your body, such as a duct. Your doctor places the stent at the end of an endoscope that is inserted through either your mouth or anus and threads it to the area of your blockage. Friction holds the stent in place, and the opening it creates allows food, stool or digestive secretions to pass through the body.

We use stents to promote healing following a procedure or to relieve an obstruction, such as a tumor or swollen tissue.

We also use gastrointestinal stents in advanced cases of cancer when a tumor cannot be removed through surgery. The primary objective in these cases is to enhance comfort and quality of life for our patients.

Endoscopic Ultrasound (EUS)

Endoscopic ultrasound (EUS) is a procedure that allows a doctor to obtain images and information about the digestive tract and the surrounding tissue and organs, including the lungs.

El Camino Health doctors are highly regarded for their skill in performing procedures using EUS. Their training, large number of cases and low complication rates give you confidence that you are receiving the best care available.

Our doctors can examine your esophagus, stomach or first part of your small intestine using a lighted, flexible tube with a camera. At the tip of the scope is an ultrasound device that uses sound waves to create images of these and surrounding digestive organs and structures.

National clinical studies show that EUS is better for spotting small tumors and gallstones than computed tomography (CT) and adds valuable information when planning treatment options.

Therapeutic endoscopic ultrasound is an evolving field of interventional endoscopy that is expanding our ability to treat gastrointestinal diseases and symptoms. Treatments include:

• Draining pancreatic cysts into the stomach and the small intestine.
• Relieving abdominal pain related to pancreatic cancer by injecting pain-relieving medicine into nerves surrounding the pancreas.
• Draining liver and abdominal abscesses (infected areas).
• Implanting stents in the bile duct and gallbladder to treat obstructions due to cancers.
• Injecting substances into the veins and arteries around the gastrointestinal tract to stop gastrointestinal bleeding.
• Placing markers in tumors to help guide stereotactic radiation therapy for precise treatment of digestive cancers.
• Ablating and eliminating gastrointestinal tumors with probes guided by endoscopic ultrasound.

Radiofrequency Ablation Therapy for Barrett's Esophagus

Barrett's esophagus (BE) occurs when an abnormal, intestinal-type lining called "specialized intestinal metaplasia" replaces the normal lining of the lower part of the esophagus.

The precancerous condition develops as a result of chronic gastroesophageal reflux disease. The reflux can cause permanent damage, and the precancerous changes may develop into esophageal cancer.

Until recently, precancerous changes and early cancer arising from BE were treated with surgical removal of the esophagus. Significant complications arising from the surgery have led to the development of safer, less invasive treatments with endoscopy.

Radiofrequency ablation is an endoscopic treatment that removes the abnormal Barrett’s lining. The procedure requires your doctor to thread an endoscope into your throat to the affected area in the esophagus. Once the flexible, lighted tube is in place, your doctor delivers radiofrequency energy (heat energy) in a precise and highly controlled manner to eliminate the abnormal tissue. Studies suggest that this ablation technique is highly effective in permanently removing the abnormal cells and in preventing progression to cancer.

Mountain View Hospital (El Camino Hospital) was one of the first centers in the Bay Area to use radiofrequency ablation to eliminate abnormal tissue in the esophagus. We have several specialists who perform this procedure and continue to be one of the most experienced centers in the area. We are the area’s only community hospital treating Barrett’s esophagus with ablation.

With radiofrequency ablation, we can remove the diseased tissue without damaging underlying normal tissue.

We may follow up with an additional upper endoscopy to assess your response to treatment and confirm that no Barrett's tissue remains. Successful elimination of the Barrett's esophagus tissue does not cure the pre-existing GERD. Your doctor will guide you in managing long-term GERD symptoms.

Radiofrequency ablation also can be effective in treating tumors in the digestive tract that are not easily removed through surgery.

Secca® Procedure for Bowel Incontinence

If you are experiencing bowel incontinence — the inability to control gas or stool — your doctor can perform a Secca procedure through a scope to improve your control of eliminating waste.

During the procedure, your doctor inserts a scope into the anus to the area where muscles are not functioning properly. Through the scope, your doctor can deliver radiofrequency energy (heat energy) to alter tissue in the anus and improve your muscles’ ability to recognize and retain stool.

Secca offers you a less invasive option for managing incontinence, as compared with surgery. It can be performed as a first choice for therapy or as an alternative if you are unable to have surgery. The Secca procedure is a minimally invasive, outpatient procedure that allows you to return to normal activities within 48 hours.