Endoscopic Diagnostics Department
The department carries out diagnostic and therapeutic endoscopy procedures due to gastrointestinal and respiratory tract, thoracic and abdominal cavities pathology.
Currently, it is one of the largest endoscopic departments in Armenia equipped with the most modern equipment and highly qualified staff. It provides a comfortable environment for patients. Before examination each patient consults with endoscopy specialist. All examinations may be complemented by biopsy, chromoscopy and Helicobacter pylori test. The immunocytochemical and immunohistochemical studies of tissues are also carried out. They are more informative and accurate diagnostic methods of benign and malignant tumors, than the regular histology.
Advantages of endoscopic ultrasound to other methods of examination. Ultrasound examination makes possible to identify abnormalities of internal organs, but only at a certain distance, beyond which neoplasms remain hidden for the doctors. Thus, there is a definite area, where neoplasms can`t be detected neither with endoscope nor by a usual ultrasound. Somehow this problem is solved by CT scanning. However, endoscopic ultrasound has significant advantages compared to all other methods, that allows to detect a number of serious diseases at an early stage, and thus increase the effectiveness of the treatment. Endoscopic ultrasound instrument allows to perform ultrasound examination of internal organs, including areas, inaccessible for a usual ultrasound. Unlike the CT scan, endoscopic ultrasound allows to examine internal cavities in various planes, following to the direction of the duct. In addition, while performing endoscopic ultrasound examination, is also possible the implementing of visually controlled sighting biopsy from the certain area of tissue under the guidance of ultrasound. All these benefits of diagnostic and surgical endoscopy over other methods raise the diagnosis and treatment of digestive system diseases to a new level.
In the Endoscopy department of Nairi Medical Centre the diagnostic and therapeutic endoscopy are carried out:
- Endoscopic retrograde cholangiopancreatography (ERCHPG)
The Endoscopy Department has:
- Modern Olympus video endoscopes (Japanese) IF, TJF, CF, BF, GIF, Viscera 160, 180.
- Auxiliary electrosurgical sets and papillotomas
- Diathermic nodes,
- Mechanical Olympus lithotriptors (Japanese) company
- Mechanical Wilson-Cook lithotriptor of Irish
- Mechanical Endoflex lithotriptors (Germany)
The technical condition of endoscopic devices is under the permanent control of high-qualified engineers for repair and service of endoscopes.
The advantages of new method of peroral endoscopic myotomy (POEM) is that it carried out without any incision on the abdomen and there is no risk of uncontrolled perforation of an esophagus that may occur during a balloon dilatation. Besides, such type of myotomy (dissection of muscles) can be implemented in more extent of the esophagus. POEM has demonstrative its relative security not only in the terms of risk of infection, but also in question of hemodynamic, respiratory and metabolic disorders. No one of the surgeries was complicated by the development of such serious complications as mediastinitis or peritonitis.
Today the doctors have a unique method of performing ultrasound examination from the close to the examining organ distance. This method is called endoscopic ultrasound examination (EUS). It allows to examine internal organs from the inside in details, seeing changes that are inaccessible in standard ultrasound examination. Examinations are implemented with the help of a special endoscope, at the end of which is not only an optic instrument, but also a tiny ultrasound probe. Usual ultrasound examination is carried out through the skin. Ultrasound, reflecting from the internal organs, comes back to ultrasound probe and makes it possible to receive the image on a computer screen. However, the power of ultrasound waves goes out in the depth of the tissues, and many organs cannot be examined in details. EUS allows to perform ultrasound examination of hollow organs of GI tract, in which echoendoscope is inserted (walls of esophagus, stomach, colon and rectum), as well as to abdominal organs, which are located nearby to stomach or intestine. These are pancreas, bile ducts, gallbladder and liver. Ultrasound scan through esophagus makes possible to create an image of mediastinal organs. In addition to internal organs, can be identified the condition of lymph nodes, located in the abdominal cavity or chest cavity.
Endoscopic ultrasound elastography
Sonoelastography during EUS allows to characterize and differentiate benign and malignant changes of lymph nodes with a high sensitivity, specificity and accuracy. Sonoelastography image complement other modes of scanning in EUS and allow more precisely to carry out fine-needle aspiration biopsy in the case of multiple lymph nodes.
In modern medicine one of the most inaccessible for examination parts of gastrointestinal tract(GIT) is a small intestine. The length of a small intestine is individual and on average is about 3-5 m. Until recently doctors could visualize only 30-40 cm of the upper small intestine(duodenum) and 10-20 cm of the lower small intestine (ileum). X-Ray and other non-invasive methods of examination can determine only gross pathology. In this way, until recently the most part of a small intestine has been remained unscreened and has been a mystery for the doctor. The newest method of video capsule endoscopy is called to solve this problem. Capsule endoscopy- is a fundamentally new method of examination of a small intestine with the help of an endoscopic capsule- a tiny capsule equipped with a camera. The advantages of the equipmentis a small size and weight, the possibility of applying without surgical or invasive intervention, absence of pain, the prevention of spread of infection while maintaining the usual activity.
The beginning of the cooperation with a Jinshancompany, which occupies a leading position in technology of video capsule endoscopy, and implementing a new innovative technology in MC Nairi will allow to raise the medicine in Armenia on a new level, particularly, in research and diagnostics of gastrointestinal diseases.