Gastro-Intestinal

The Gastro-intestional Procedures our doctors can perform fall under one of these categories.

• Bariatric Artery Embolization (Nanoblock): inject tiny particles into the side of the stomach blocking the release of ghrelin
• Chemoemoblization of Liver Tumors: direct application of chemotherapy drugs to a tumor while also blocking (embolizing) a blood vessel to reduce blood flow to the tumor.
• Mesenteric and Celiac Angiography and Stenting: examination and placement of a mesh tube (stent) to open and support a mesenteric or celiac artery that has collapsed or been narrowed by plaque buildup. Includes mesentric angiogram.
• Percutaneous Transhepatic Biliary Drainage (PTBD): procedure to drain the bile ducts in the presence of a blockage or damage that prevents normal bile drainage.
• Percutaneous Transhepatic Cholangiograms (PTCA): X-ray of the bile ducts in and around the liver.
• Paracentisis and Peritoneal Port Placement: drainage of peritoneal fluid in the belly as well as port placement to simplify repeated paracentisis.
• Percutaneous Endoscopic Gastronomy (PEG): procedure in which a gastronomy tube (G-tube) is put in place to allow enteral feeding.
• Radiofrequency Ablation (RFA) for Liver Tumors: application of radiofrequency energy to destroy tumor tissue in the liver.
• Transjugular Intrahepatic Portosystemic Shunts (TIPS): procedure to create a new path from the portal vein directly into the main venous system through a vein in the liver.
• Transjugular Liver Biopsy: technique for gathering cells for liver biopsy without piercing the liver from outside the body.

APPETITE HORMONE

Researchers have found that there is an appetite hormone made in the lining of the stomach called ghrelin. When patients have low levels of ghrelin in their system, their appetites are suppressed.

By reducing the amount of blood flow to the stomach lining where the cells reside that are releasing this appetite hormone, our physicians have a very unique way of deadening or suppressing the appetite. By suppressing the appetite, patients are able to lose weight in a natural and healthy manner, simply by eating less.

APPETITE SUPPRESSION PROCEDURE

Our physicians introduce a small catheter into the radial artery in the wrist or the femoral artery in the groin and utilize live x-ray imaging to guide the catheter to the artery that supplies blood to the left side of the stomach. Here the physician safely injects tiny particles that are just large enough to block and kills the cells that make the appetite hormone. These particles have been used by physicians for 20 years to close down blood vessels in the stomach and other organs. It is an outpatient procedure taking about an hour, the patients are typically at the facility for a total of 3-4 hours with recovery, before they go home.

Chemoembolization is a procedure in which chemotherapy drugs are delivered directly to a cancerous tumor, most often in the liver. In addition to the chemotherapy drugs, the blood vessels feeding the tumor are embolized, reducing the tumor’s ability to thrive.

During the procedure, an angiogram is performed so that the arteries that are supplying blood to the tumor can be identified. The chemotherapy drugs are then delivered into the artery so that they move directly to the tumor. After the drugs have been delivered, polyvinyl particles are released in the artery to further starve the tumor of oxygen and nutrients.

Chemoembolization has several benefits over traditional chemotherapy: the drugs are injected directly to the tumor and are more concentrated, the drugs continue to affect the tumors for up to a month, there are fewer side effects because the drugs do not circulate through the body, and the tumors are starved of oxygen and nutriets because the blood supply is compromised.

Chemoembolization is a catheter-based procedure that our doctors perform at Good Samaritan Hospital. The procedure takes about an hour and a short hospital stay is expected.

Celiac and mesenteric angiography are procedures in which the celiac and mesenteric arteries are studied via fluoroscopy (live X-ray). Both the celia and mesenteric arteries are located in the belly, and are the major branches of the abdomial aorta.

The celiac (or coeliac) artery is the first major branch of the abdominal artery and supplies oxegenated blood to the stomach, liver, spleen, the abdominal esophagus, and parts of the duodenum and pancreas. The superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) form the other two branches of the abdominal artery, and supply the colon, the ileum, cecum, appendix, jejunum, and parts of the duodenum.

A celiac or mesenteric angiogram can detect or rule out aneurysm, thrombosis, ischemia, and can be used to locate the source of gastrointestinal bleeding. It can also aid in the diagnosis of portal hypertension and cirrhosis.

If either the celiac or SMA artery is found to be restricted or narrowed, a stent can be placed to hold the vessel open and allow blood to flow freely.

Celiac and mesenteric angiography are catheter-based procedures that our doctors perform in our freestanding facility. The procedures can take up to three hours, depending on the number of vessels explored. No overnight stay is required.

Celiac and SMA stent placement are catheter-based procedures that our doctors perform in our freestanding facility. The procedure takes about an hour and no overnight stay is required.

Paracentesis is a procedure in which excess peritoneal fluid that has built up in the belly is removed through a long thin needle.

Fluid buildup may occur once as a result of an injury or infection, but some disorders, such as cancer or cirrosis, may cause fluid to build up continually. When fluid buildup is chronic and paracentesis is required on a regular basis, a port may be installed to allow for easier removal of the fluid.

Paracentesis may be performed to relieve pressure in the belly or to gather peritoneal fluid for analysis.

Paracentesis is a needle-based procedure that our doctors perform in our freestanding facility. The procedure takes about 30 minutes and no overnight stay is required.

Paracentesis port placement is a procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure will take one or two hours, and a short hospital stay is expected.

A percutaneous transhepatic cholangiogram (PCTA) is an X-ray of the bile ducts in and around the liver.

The fluoroscopy (live X-ray) machine is used to guide a needle into the bile ducts, then x-ray contrast medium is injected into the bile ducts. The medium can be seen flowing through the ducts if there are no blockages. Blockages can be identified for further treatment.

PCTA is a needle-based procedure performed in our freestanding facility in Dayton, Ohio. The procedure will take about an hour and no overnight stay is required.

Percutaneous transheptic biliary drainage (PTBD) is a procedure to drain the bile ducts in the presence of a blockage or damage that prevents normal bile drainage. Blockage can be diagnosed with a percutaneous transhepatic cholangiogram (PCTA).

Using fluoroscopy (live X-ray), a needle is guided into the bile ducts, where a contrast agent is injected to allow visualization on a monitor. A catheter is placed into the bile duct to allow the bile to drain out into a bag outside the body. To prevent further drainage difficulties, a stent may be placed in a blocked or restricted bile duct to hold it open and allow bile to flow freely.

PTBD is a needle-based procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure takes 1-2 hours and a short hospital stay is expected.

Percutaneous endoscopic gastronomy (PEG) is the procedure in which a gastronomy tube (G-tube) is put in place to allow enteral feeding when feeding by mouth is likely to be impossible or contraindicated for four or more weeks.

In PEG, a tube is placed into the stomach through the abdominal wall using an endoscope, a lighted instrument, for guidance.

PEG is a procedure that our doctors perform at Good Samaritan Hospital in Dayton, Ohio. The procedure will take one or two hours. A short overnight stay is expected.

Radiofrequency ablation (RFA) is a procedure that uses radio waves to destroy damaged or abnormal tissue. It may be used to close a damaged vein to force healthy veins to take over its function. It may be used to destroy cancerous tumors in the liver or lungs.

When RFA is used to treat tumors, a hollow needle is guided directly into the tumor using fluoroscopy (live X-ray) for guidance to ensure precise placement. Once the needle is in place, a set of tiny metal wires is extended and radiofrequency energy is applied.

When RFA is used to treat damaged or malformed blood vessels, the tiny metal wires are transported to the correct location with a catheter that travels through your blood vessels.

Portal hypertension is high blood pressure (hypertension) in the portal vein and branches. The portal system is located in the abdomen near the stomach and liver. Portal hypertension can occur when the liver is unable to process the blood from the bowels (due to liver failure or cirrosis), forcing the blood from the bowels to pool or force its way through other paths to return to the circulatory system. The fragile veins that often bear the brunt of the rerouting are likely to rupture under increased pressure.

A transjugular intrahepatic portosystemic shunt (TIPS) creates a new path from the portal vein directly into the main venous system through a vein in the liver. It uses a flexible tube called a stent to form this new vessel.

TIPS is a catheter-based procedure that our doctors perform at Good Samaritan Hospital. The procedure takes about an hour and a short hospital stay is expected.

Transjugular liver biopsy or transvenous liver biopsy is a procedure in which cells from the liver are gathered for examination through an innovative technique that doesn’t require piercing the liver from outside the body.

Biopsies are usually done by inserting a small needle inserted directly into the liver and extracting the necessary cells. This type of biopsy can be difficult to perform if the patient has large amounts of fluid in the abdomen, and piercing the liver with the biopsy needle can cause complications in patients with bleeding disorders.

In transjugular liver biopsy, a catheter is inserted into the jugular vein and guided via fluoroscopy (live X-ray) to a primary vein of the liver. The biopsy needle is then threaded through the catheter and guided into the liver to gather tissue. Any blood lost from the liver simply returns to the bloodstream, resulting in minimal blood loss.

Transjugular liver biopsy is a catheter-based procedure that our doctors perform in our freestanding facility. The procedure takes about an hour and no overnight stay is required.