Division of Gastroenterology - Liver Research Center 















 

Endoscopy Unit

The Rhode Island Hospital Endoscopy Unit occupies 9000 square feet on the 9th Floor of the Zecchino Pavilion (Main Building). The unit is newly constructed. Operations commenced in May 2002. The unit is one of the busiest and most up-to-date on the East Coast. It consists of patient interviewing/preparation rooms, a multi-use diagnostic/motility/technology room, four multi-purpose procedure rooms, a fluoroscopy/procedure room which contains a Phillips Diagnost Digital Fluoroscopy Unit, a scope re-processing room, which is capable of handling eight scopes at once, and a recovery suite. The Fluoroscopy unit features grid-controlled pulsed fluoroscopy, which improves image quality while reducing the radiation dose to the patient. Endoscopy reports are prepared on a digital system that can generate written reports with full color images and interface with the Lifespan system-wide database.

The unit is structured to offer patients maximum privacy and comfort. Expedited registration and check-in, private interviewing and changing rooms, and a comfortable and airy recovery room all enhance the patient's experience. Our skilled and dedicated nursing staff provide outstanding emotional support to the patient and technical support to the physician. The Endoscopy Unit is staffed by both full-time hospital-based academic faculty and community-based voluntary faculty, all of whom have Brown University academic appointments.

The facilities and staffing allow for the performance of all state-of-the-art diagnostic and therapeutic procedures. Upper endoscopic procedures include diagnostic endoscopy with or without biopsy, balloon and bougie dilation of strictures, bleeding control using electrocoagulation, argon plasma photocoagulation, injection/sclerotherapy, application of hemoclips, and band ligation, palliation of malignant strictures using expandable stents or photodynamic therapy, placement of feeding tubes in the stomach (PEG) or small bowel (PEJ), and removal of foreign bodies. Biliary procedures, including diagnostic and therapeutic ERCP, allow for stone disruption and removal, diagnosis and treatment of biliary infections including cholangitis, diagnosis, staging, and palliative treatment of ampullary, biliary and pancreatic strictures or tumors, and the diagnosis and treatment of atypical causes of recurrent pancreatitis. Endoscopic ultrasound allows for staging of esophageal, gastric, colon, and rectal cancers, evaluation of submucosal tumors anywhere in the GI tract, evaluation of mediastinal lymph nodes, diagnosis and staging of pancreatic and bile duct cancer (including lymph node assessment, aspiration cytology, and assessment for vascular invasion), and evaluation of cystic lesions of the pancreas (pseudocyst vs. benign vs. malignant neoplasms). Colonoscopic procedures include colorectal cancer screening, biopsy and polypectomy, endoscopic control of bleeding, decompression of the bowel, removal of foreign bodies, and dilation or palliation of strictures.

The Endoscopy Unit offers a number of non-endoscopic diagnostic tests, including catheter and capsule based 24-hour pH studies, esophageal and anal manometry, sphincter of oddi manometry, capsule endoscopic imaging of the small intestine, and quick and highly sensitive breath tests to assess for H. Pylori infection.

Translational research is conducted in our unit in collaboration with our academic and voluntary staff. Currently, we are involved in studies assessing for genetic alterations associated with the development of Barrett's esophagus, the role of H.Pylori in GERD, H.Pylori antibiotic resistance patterns, and the use of photodynamic therapy in malignant biliary strictures. Several of these studies are conducted in association with the recently awarded Brown University/Rhode Island Hospital Center of Biomedical Research Excellence (COBRE) grant. Additional studies may be performed in conjunction with the Lifespan Comprehensive Cancer Center.