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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.
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