Interventional endoscopy procedures are minimally invasive techniques performed using specialized endoscopes, equipped with cameras and lighted tips, offering a broad range of applications, from diagnosis and staging to the treatment of complex gastrointestinal (GI) issues.

Depending on the specific condition, the endoscope is inserted through either the mouth or rectum, enabling gastroenterologists to obtain detailed images of the GI tract.  Specialized endoscopes with ultrasound probes at the tip allow for visualization of adjacent organs next to the GI tract such as the pancreas, gallbladder, liver, bile ducts, and lymph nodes.

The advantage of these procedures is that they allow for the passage of small instruments through the endoscope, facilitating the collection of tissue samples and performing other interventions from within. These are minimally invasive alternatives to surgery, offering shorter treatment and recovery times, fewer complications, and lower costs compared to traditional surgery, and often enabling patients to return home on the same day.


Endoscopic Retrograde Cholangiopancreatography (ERCP)

  • Bile duct stones and strictures
  • Bile duct stent placement for benign and malignant strictures
  • Cholangioscopy and pancreatoscopy (Spyglass® ERCP)
  • Endoscopic ampullectomy
  • ERCP in post-surgical anatomy
  • Lithotripsy of bile duct and pancreatic stones
  • Pancreatic duct stent placement for chronic pancreatitis
  • Combined laparoscopic-endoscopic procedures


Endoscopic Ultrasound (EUS

Diagnostic EUS:

  • Fine Needle Aspiration and biopsy (FNA/ FNB) of lesions adjacent to the gastrointestinal tract (e.g. pancreas, liver, lymph nodes)
  • Evaluation of subepithelial lesions in the lining of the GI tract
  • Staging of gastrointestinal cancers


Therapeutic EUS:

  • EUS-guided drainage of pancreatic fluid collections and walled off necrosis
  • EUS-guided pancreatic duct and bile duct drainage
  • EUS-guided gallbladder drainage
  • EUS-guided gastroenterostomy
  • EUS-guided medical liver biopsy
  • Fiducial marker placement for radiation therapy
  • Nerve blocks (celiac plexus block/neurolysis)


Submucosal (Third Space) Endoscopy

  • Endoscopic Submucosal Dissection (ESD) for early cancers or precancerous lesions of the GI tract
  • Endoscopic therapy for Zenker’s diverticulum (cricopharyngeal myotomy)
  • Gastric Per-Oral Endoscopic Myotomy (G-POEM) for gastroparesis
  • Per-Oral Endoscopic Myotomy (POEM) for achalasia (swallowing disorder)


Procedures used in treating Barrett’s esophagus, colon and stomach polyps, and early GI cancers include:

  • Endoscopic Mucosal Resection (EMR)
  • Endoscopic Submucosal Dissection (ESD)
  • Radiofrequency Ablation (BarrxTM)


Interventional endoscopy procedures are also used for:

  • Deep small bowel endoscopy
  • Endoscopic suturing
  • Esophageal, duodenal and colonic stent placement
  • Treating heartburn and gastroesophageal reflux disease (GERD) (TIF®)

An endoscope is a flexible tube equipped with a camera that provides real-time images of the gastrointestinal tract. It also allows the passage of instruments for procedures.

Diagnostic procedures are done to further evaluate a particular symptom or imaging finding to help determine what is wrong. An example is obtaining a biopsy (or small piece of tissue). Therapeutic procedures are done to fix a problem. Examples include removal of precancerous growths and removing a stone from the bile duct.

Typically, upper GI procedures require an overnight fast, while colon procedures necessitate a full bowel prep. Your physician will provide specific instructions for your case.

Yes, these types of procedures require a referral from your primary care physician or another GI specialist who does not offer interventional endoscopy. United Digestive partner practices participate in most health plans, so please check with your insurance carrier for your plan’s specific referral requirements.