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Medical Journal Erebouni

Endoscopy Department

General characteristics

Endoscopy department of Erebouni Medical Centre is a multi-profile department where diagnostic and therapeutic endoscopy procedures in the pathology of gastrointestinal and respiratory tract, organs of thorax and abdomen are performed.
Each year, the department carried out 2150 - 2500 endoscopic procedures.


Currently, it is one of the largest endoscopic departments in Armenia equipped with the most modern equipment and staffed highly qualified specialists. It provides a comfortable environment for patients. Each patient is consulting by endoscopist specialist.
All examinations may be complemented by biopsy, chromoscopy, Helicobacter pylori test. The immunocytochemical and immunohistochemical studies of tissue that are more informative and accurate methods of benign and malignant tumors diagnostics than the regular histology are also provided.


In addition to diagnostic procedures the complete list of emergency and planned endoscopic interventions including range from polypectomy to endoscopic surgery on the bile and pancreatic ducts are performed at the department


Minimally invasive surgery can significantly reduce the period of hospitalization and minimize the period of rehabilitation in comparison with the traditional operations.


In the Endoscopy department of Erebouni Medical Centre the diagnostic and therapeutic endoscopy are carried out:

 

  • Esophagogastroduodenoscopy
  • Colonoscopy
  • Bronchoscopy
  • Endoscopic retrograde cholangiopancreatography (ERCHPG)

 

Esophagogastroduodenoscopy (abbreviated is gastroscopy or EGDS) is performed for the detailed examination of the mucous membrane of the esophagus, stomach and duodenum in case of the suspicion for the tumor or bleeding of those organs, peptic ulcer  and/or duodenum ulcer, gastritis, duodenitis, esophagitis. The gastroscopy may be indicated also as an additional examination for the differencial diagnosis in case of some other diseases not related to gastrointestinal tract (allergy, neurosis).

 

Erebouni Medical Center: Clinic of Diagnostic: Endoscopy Department


The indication for the gastroscopy are  any abdominal pain, diarrhea disorders, heartburn, weight loss, nausea and vomiting, abnormal or painful swallowing, anemia.


The gastroscopy may be accompanied also by the implementation of a number of therapeutic procedures: removal of polyps and some kind of tumors of the gastrointestinal tract, removal of the foreign bodies, control of gastrointestinal bleeding, dilation of the narrowing (strictures) of gastrointestinal tract. These delicate interventions give the opportunities to avoid the big surgeries on the abdominal organs. For the treatment of obesity a special balloon is placed in the stomach and helps to decrease amount of consumed food, contributing to effective reduction of the weight (BIB- system).

 

Erebouni Medical Center: Clinic of Diagnostic: Endoscopy Department


Colonoscopy is performed for visualization and detailed study of the colonic mucosa, including rectum, sigmoid colon, colon, caecum and ileum in case if the tumors or bleedings of these organs, colitis, unspecific inflammatory diseases (Crohn’s  disease, nonspecific ulcerative colitis), diverculum of colon, as well as for diagnostic purpose in case of other diseases as an additional examination (allergy, neurosis).


The indication for colonoscopy are any abdominal pain, diarrhea disorders, weight loss, nausea and vomiting, anemia. According to international standards it is believed that the age over 40 years is also considered as an indication for the colonoscopy.


In addition to diagnostic procedures during the colonoscopy it is possible to successfully remove polyps and some kind of tumors of the colon, to extract a foreign bodies, to perform hemostasis in case of intestinal bleeding and dilate narrowed part of the colon  (stricture) These delicate intervention give the opportunity to avoid the major surgery on the abdomen.


Erebouni Medical Center: Clinic of Diagnostic: Endoscopy DepartmentBronchoscopy is carried out for the detailed study of the mucous membranes of the respiratory tract in case of suspicion of the tumors or bleedings of these organs, bronchitis, nonspecific inflammatory lung diseases, tuberculosis, bronchial asthma. The bronchoscopy is performed as when inhaled foreign body or as an additional examination for diagnosis of other diseases (allergy, neurosis).


The Indication for bronchoscopy are chest pain, secretion of sputum, especially with the admixture of pus and blood, shortness of breath, chronic cough, weight loss, anemia.


During bronchoscopy it is possible to performe also following therapeutic procedure: biopsy of trachea and bronchi mucous, swabs from different parts of the lungs for cytological or microbiological studies to determine the patogenetic agent and its sensitivity to antimicrobial treatment, removal of polyps and some other kind of tumors of trachea and bronchi, extraction of the foreign bodies, pulmonary hemostasis, dilation of the strictures in respiratory tracts. These delicate interventions give the opportunity to avoid large surgeries on the organs of respiratory tract.


 Endoscopic retrograde cholangiopancreatography (ERCP) is carried out to study the condition of the bile and pancreatic ducts. It is a combination of endoscopy and X-Ray examination after the administration of contrast medium into the bile and pancreatic ducts. In addition to obtaining the images of the biliary tract and the pancreas, the Endoscopic retrograde cholangiopancreatography allows to examine the upper part of gastrointestinal tract and the peri-ampullary area, as well as perform a biopsy or surgical intervention..


The Indication for Endoscopic retrograde cholangiocpancreatography are abdominal pain, pain in the right hypochondrium, epigastria, chronic diseases of the bile and pancreatic ducts, suspicion of the concernments in the bile and pancreatic ducts, diseases of the pancreas, mechanical jaundice of unclear genesis, suspicion to the tumor of pancreaticoduodenal region, etc.


Depending on obtained results, at the time of endoscopic examination it is possible to perform such intervention procedure as endoscopic dilation of pathologically narrowed bile duct (stenting), removal of the cholelith, sphincterotomy, etc.

 
Equipping

The Endoscopy Department has:

 

  • Modern video endoscopes of Japanese «Olympus» company IF, TJF, CF, BF, GIF Viscera 160, 180.
  • Auxiliary electrosurgical set and papillotomy
  • Diathermic nodes,
  • Mechanical lithotriptor of Japanese «Olympus» company
  • Mechanical lithotriptor of Irish «Wilson-Cook» company
  • Mechanical lithotriptors of German «Endoflex» company


The technical condition of endoscopic devices is under the permanent control of high-qualified engineers for repair and service of endoscopes.


Processing and sterilization of endoscopic equipment meets contemporary patient's safety requirements.
The permanent control of microbial contamination allows keep optimal sanitary and epidemic conditions of environment. The equipment passes all processing steps, starting with the mechanical cleaning and finishing with high-level of disinfection. Endoscopic toolset is sterilized and maintained in sterile conditions.

 
Main activities

  Diagnostic endoscopy


In Endoscopy Department of Erebouni Medical Centre are introduced and routinely performed the following diagnostic endoscopy procedures:

 

  • Esophagogastroduodenoscopy (EGDS)
  • Colonoscopy
  • Bronchoscopy
  • Endoscopic retrograde cholangiopancreatography


  Therapeutic endoscopic surgical  and interventional procedures

They are performed under the local anesthesia, with moderate or deep sedation, or under the endotracheal anesthesia.

 

  • Electrocoagulation of the bleeding locum in the stomach and duodenum, or respiratory tract
  • Removal of the foreign bodies from the esophagus, stomach, duodenum, respiratory tract
  • conduction of the nutrient probes into the lower parts of the esophagus, stomach and duodenum for the feeding and also for prevention of the insufficiency of the seams of the operated patients
  • endoscopic placement of the balloon in the stomach for the weight loss
  • biopsy of the mucous of stomach, duodenum, respiratory tract with consequent cytological and histological sudy
  • endoscopic removal of colon polyps
  • bronchoscopic lavage of the bronchi
  • endoscopic dilation of the bile duct (biliar hypertension)
  • endoscopic wirsungotomy as independent or one of the stages of decompression of pancreatic duct
  • endoscopic dilation of the main pancreatic duct (pancreatic hypertension)
  • endoscopic papillotomy (papillosphincterotomy) EPST   
  • biliary duct stenting
  • endoscopic lithotripsy and lithoextraction – crushing and removing of the chololiths (concrements) in the cholecyst and the bile ducts
 
Staff
Ruben Kanayan, MD Ruben Kanayan, MD Write a letter Head of Endoscopy Department endoscopist PhD (c.m.s.)
Armenak Meltonyan Armenak Meltonyan Write a letter endoscopist MD
Manvel Paskevichyan, MD Manvel Paskevichyan, MD Write a letter gastroenterologist, gastroscopist
Ferdinand Snkhchyan, MD Ferdinand Snkhchyan, MD Write a letter endoscopist
Narek Zeynalyan, MD Narek Zeynalyan, MD Write a letter endoscopist PhD
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