Interventional Endoscopy Procedures & Services

What is peroral endoscopic myotomy (POEM)?

Peroral endoscopic myotomy (POEM) is minimally invasive procedure that uses endoscopic technology to treat digestive and swallowing disorders. This incisionless technique offers quick recovery and treats rare digestive disorders such as achalasia, a disorder of the esophagus that makes it difficult to consume food.

During the procedure an endoscope is inserted into the mouth and moved through the throat creating a tunnel between layers of the esophagus. When the endoscope reaches the lower esophageal sphincter, an incision is made in the muscle, permanently opening the value.

UChicago Medicine is one of the few centers in Chicago and Illinois offering peroral endoscopic myotomy (POEM) to patients for the treatment of digestive and swallowing disorders.

Learn more about the POEM procedure

What is endoscopic submucosal dissection (ESD)?

Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic resection technique to examine and remove growths from the lining of the GI tract. This includes Barrett's esophagus nodules, complex colon polyps and duodenal adenomas. This technique was developed as an alternative to standard surgical procedures. Due to the increased technical difficulty, ESD is only available at a few selected care centers in the United States.

Endoscopic resection is one of our team's main areas of research. We were one of the first groups in the nation to perform endoscopic mucosal resection (EMR). Our experience performing EMR spans 15 years and thousands of cases. Therefore, it is natural evolution for use to now perform ESD.

Endoscopic submucosal dissection (ESD) can be considered for:

• Superficial esophageal cancer (both squamous or adenocarcinoma)
• Early gastric cancer
• Early colorectal cancer (limited to the superficial submucosa)
• Non-lifting colorectal lesions

Learn more about the ESD procedure

What is photodynamic therapy (PDT) for cholangiocarcinoma?

Cholangiocarcinoma is a relatively rare cancer of the bile ducts with approximately 5,000 cases annually in the United States. For more than 80 percent of patients, the disease is unresectable. Therapy options traditionally have been limited to chemotherapy and palliative bile duct stenting to relieve jaundice.

In photodynamic therapy (PDT), the patient receives an IV porphyrin sensitizer 48 hours prior to endoscopic application of light to the tumor with the purpose of causing cell death. The light is delivered via a flexible fiber during endoscopic retrograde cholangiopancreatography (ERCP) at the time of biliary stent placement or exchange. 

Although data on the use of PDT in cholangiocarcinoma is limited, initial studies in patients with unresectable disease have suggested the treatment not only aids biliary decompression, but also improves survival through actual tumor destruction. The main side effect of this therapy is severe photosensitivity for 30 days for which the patients must be counseled.

UChicago CERT is the only center in the city to offer PDT for therapy of unresectable cholangiocarcinoma.

We also have expertise in:

• Endoscopic ultrasound (EUS) with fine needle aspiration (FNA)
• Celiac plexus neurolysis
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Cholangioscopy
• Photodynamic therapy (PDT) ablation of cholangiocarcinoma
• Lithotripsy of large biliary and pancreatic duct stones
• Ampullectomy
• Endoscopic mucosal resection (EMR)
• Endoscopic submucosal dissection (ESD)
• Complex polypectomy in the colon and duodenum
• Radiofrequency ablation (RFA) and cryotherapy
• Pancreatic pseudocyst drainage and necrosectomy
• Palliative stenting of GI tract and pancreaticobiliary malignancies
• Extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones
• Peroral endoscopic myotomy (POEM)
• Zenker's diverticulotomy/ myotomy