Memorial Sloan Kettering physicians perform more than 5,300 endoscopic procedures annually, including the following techniques.

Endoscopic Retrograde Cholangiopancreatography

Video: The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP)
Gastroenterologist Mark Schattner describes endoscopic retrograde cholangiopancreatography (ERCP), a minimally invasive method used to treat obstructions and strictures in the biliary ducts.

Endoscopic retrograde cholangiopancreatography (ERCP) is useful for staging and treating pancreatic and bile duct cancers. During this procedure, pancreatic or biliary cells may be removed for analysis, and an opaque dye is injected to determine, using x-rays, whether the bile duct has narrowed or become blocked. ERCP also can be used therapeutically to insert a stent into an obstructed bile duct to relieve jaundice and alleviate pain.

Colonoscopy

Video: The Role of Colonoscopy
Gastroenterologist Mark Schattner outlines the advantages of undergoing colonoscopy at Memorial Sloan Kettering.

A colonoscopy is the most effective way to detect polyps in the colon and rectum. Before the procedure, the bowel must be evacuated. The patient receives a mild sedative, and the doctor inserts an endoscope into the rectum and colon. As the endoscopic camera is guided through the colon, it transmits images to a screen. The doctor is able to look for polyps, which can be removed and sent to a pathologist for examination.

Upper Endoscopy

Video: The Role of Upper Endoscopy
Gastroenterologist Mark Schattner describes applications of upper endoscopy as a minimally invasive diagnostic approach.

Our gastroenterologists use upper endoscopy to visualize the interior of the esophagus, stomach, and duodenum, and for the diagnosis and staging of tumors in these organs. Advanced endoscopic techniques, such as endoscopic ultrasound and endoscopic retrograde cholangiopancreatography (ERCP), are used to examine the pancreatic and bile ducts and to perform interventional diagnostic, staging, and therapeutic procedures.

Endoscopic mucosal resection (EMR) is available to remove precancerous esophageal tissue or early-stage esophageal tumors. EMR may also be combined with radiofrequency ablation to treat conditions such as Barrett's esophagus.

Endoscopic Ultrasound

Video: The Role of Endoscopic Ultrasound
Gastroenterologist Mark Schattner discusses how endoscopic ultrasound (EUS) has expanded from a diagnostic technique to a staging and treatment tool for gastrointestinal cancers.

An endoscopic ultrasound (EUS) provides a cross-sectional picture of the walls of the esophagus, stomach, and duodenum. It can also be performed to examine the pancreas, rectum, and lymph nodes. EUS is often done just after an upper GI endoscopy, though using a slightly larger tube.

Our physicians employ EUS to see how deeply a tumor has invaded tissue. It can also be used to determine whether any lymph nodes are enlarged, to detect a tumor in nearby tissues, and to monitor tumor response to treatment.

EUS can be combined with a needle biopsy to obtain a small piece of tissue for analysis and to extract fluid from cysts.