Endoscopic Diagnosis
General characteristic
In the frames of endoscopic diagnostics, we perform diagnostic and treatment procedures due to pathology of the organs of gastrointestinal tract, respiratory organs, organs of thoracic and abdominal cavity. At present, it is one of the first-rate endoscopic services in Armenia that is equipped with the most modern equipment and has a high-quality staff. In our hospital we have created all comfort conditions for our patients. Before performing an examination each patient has a consultation of a doctor – endoscopist.
All examinations may be performed combined with biopsy, chromoscopy and Helicobacter pylori test.
We also perform immunocytochemical and immunohistochemical examinations of tissues, which are more informative and accurate methods of diagnostics of benign and malignant neoformations than the regular histology.
Advantages of endoscopic ultrasound
Ultrasound gives an opportunity to detect anomalies of internal organs only on the certain distance, out of which neoformations are still hidden from the doctors’ view. In certain degree, this problem solves the CT scan method. But the endoscopic ultrasound has an advantageous difference from all above – mentioned methods allowing to discover quite a number of serious diseases in the early stage and, hence, essentially increases an effectiveness of the treatment.
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Endoscopic ultrasound allows to perform ultrasound examination of internal organs, including the inaccessible for the regular ultrasound examination regions. As opposed to CT scanning, the endoscopic ultrasound allows to examine inner cavities in different bends, following the duct’s direction. In addition, during performance of endoscopic ultrasound examination it is possible to carry out visually controlled (with the help of ultrasound) target biopsy of concrete region. Alongside with diagnostic procedures, we perform quite a number of emergency and planned endoscopic operations: from polypectomy to endoscopic surgeries on gall ducts and pancreatic ducts.
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Principal activities
At “Nairi” Medical Center we perform medical and diagnostic endoscopy:
- esophagogastroduodenoscopy,
- colonoscopy,
- bronchoscopy,
- endoscopic retrograde cholangiopancreatography, ERCP.
Equipment
- modern video endoscopes, Japanese company “Olimpus” IF,TJF,CF,BF,GIF Viscera 160,180,
- auxiliary electrosurgical blocks and papillotoms,
- diathermic knots,
- mechanic lithotripters, Japanese company “Olimpus”,
- mechanic lithotripters, Irish company “Willson-Cook”,
- mechanic lithotripters, German company “Endoflex”.
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Technical state of endoscopic devices is under the permanent control of highly skilled engineers for repair and service of endoscopes.
Oral Endoscopy
The advantages of new method of oral endoscopic myotomy is that it is performed without one single incision in abdominal cavity, there is no risk of uncontrolled perforation of esophagus that can occur during balloon dilation. Besides, this type of myotomy (muscles insection) may be performed on the larger space of esophagus. Oral endoscopic myotomy has demonstrated its relative safety not only from the infection risk point of view, but also from the point of view of hemodynamics, respiration and metabolic disorders. Neither one of the surgeries has been complicated by development of serious complications such as mediastinitis or peritonitis.
ENDO ULTRASOUND EXAMINATION
For today our doctors possess a unique method – ultrasound examination from inside, with the immediate vicinity to examined organs. This method is called endoscopic ultrasound examination. It allows to observe internal organs in details noticing the changes, which are inaccessible during standard ultrasound examination. The examination is performed with the help of special endoscope, on the end of which besides the optical device, there is attached also a little ultrasound probe.
Flexography during endo ultrasound examination.
Ultrasound-flexography during endoscopic ultrasound examination allows to characterize and differentiate benign and malignant changes of lymphatic nodes with high sensitivity, specificity and accuracy. Ultrasound-flexographic image completes other regimes of scanning during endo ultrasound examination and in case of multiple affection of lymphatic nodes, allows to perform more targeted fine needle aspiration biopsy.
One of the most difficult regions of gastrointestinal tract for examination in the contemporary medicine is the small intestine. The length of small intestine is individual and on the average is around 3-5 meters. Until recently doctors could visualize only 30-40cm of the upper regions of small intestine (duodenum) and 10-20cm of the lower region (iliac intestine). X-Ray and other invasive methods of examination can determine only rough pathology. Hence, until recently, most part of the small intestine remained unexplored and was a puzzle for doctors. This problem can be solved by the method of capsular endoscopy. Capsular endoscopy is a brand new method of small intestine examination with the help of endoscopic capsule – diminutive device with built – in video camera.
Advantages of this device – small volume, little weight, possibility to use without surgical or invasive intervention, pain-free, exclusion of infection transfer during patient’s regular activity maintenance etc.
Beginning of collaboration with the leading technologic Chinese company Jinshan and introduction of innovative technologies to Nairi Medical Center will allow to raise medicine of Armenia to the world level, particularly, in the field of researches and diagnostics of gastrointestinal diseases.
Doctors
Vardges R. Kanayan, MD, endoscopist, Head of Endoscopic Diagnosis
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