October 12, 2010
CAMC has recently begun offering several new, state-of the art endoscopy procedures that offer many advantages for patients. superDimension The human lungs are like tree branches because there are many divisions within them. A regular scope cannot reach the outer two-thirds of the lungs, meaning that, in the past, people with suspicious nodules were put primarily on a "wait and watch" course of treatment, which is frightening for all involved. With the superDimension system, a bronchoscope can extend to regions deep within the lung. "It works like GPS works in a car," said Tom Takubo, DO. "A catheter is used to look at sensors placed on the chest and is guided through the complex lung system." Using these sensors, a three-dimensional roadmap of the lung is transferred to a special software system to track the real-time position of the guide catheter. This targets lesions in the lungs. Once arriving at a target, the location sensor is removed and the guide catheter provides a channel for diagnostic or therapeutic tools. "This system will allow us to catch lung cancers much earlier," Takubo said. "This is the first significant advancement in years that actually might increase the survival rate of those diagnosed with lung cancer, and right now only 5 percent of hospitals in the country are using it." Endoscopic Ultrasound (EUS) Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs. "When the procedure is performed, conscious sedation is administered. Once the patient is sleepy, a special endoscope is inserted which has a camera for direct visualization of the esophagus, stomach and small bowel; as well as an ultrasound probe for examination of surrounding structures," said Jeremy R. Stapleton, DO. At that time, the physician observes the inside of the intestinal tract on a TV monitor and the ultrasound image on another monitor. The entire procedure takes about 30 to 90 minutes, depending on the complexity and whether or not fine needle aspiration (FNA) is performed. "Endoscopic ultrasound has become a crucial part of the diagnosis, staging and management of numerous gastrointestinal and mediastinal diseases," Stapleton said. EUS can help diagnose via FNA and stage gastrointestinal and mediastinal cancers, detect common bile duct stones, assess masses of the gastrointestinal lining, assess enlarged stomach folds that may be involved with cancer deep in the stomach wall and unreachable by surface biopsies, diagnose diseases of the internal organs, and safely and accurately collect fluid samples from the lungs or the abdominal cavity for analysis. "There are probably fewer than five physicians performing this procedure throughout the state, and three of them are here at CAMC," Stapleton said. "It can have extremely important implications in diagnosis and management through diagnostic FNA and staging of cancers." SpyGlass SpyGlass is a new endoscope that can directly visualize biliary and pancreatic ducts. While a standard endoscopic retrograde cholangiopancreatography (ERCP) creates two-dimensional black and white X-ray images, the SpyGlass system overcomes these restrictions by using a small, flexible tube to access hard to reach areas and physically enter the ducts to spot causes of disease and blockages. The ability to literally look inside a tiny bile duct and take clear images allows for quicker and more accurate diagnoses. Repeat tests are also needed less, which is more convenient for patients.

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