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Endoscopy

The Alvin M Zfass Endoscopy Unit is a state of the art facility providing both routine and advanced endoscopic care to over 7000 patients annually. The primary mission of the endoscopy unit is to deliver high quality, compassionate endoscopic care in both inpatient and outpatient settings. The endoscopy unit also serves to implement, evaluate and develop new endoscopic technologies and techniques. Finally, the unit serves as the primary location for endoscopic training of both gastroenterology fellows and surgical residents.

A wide variety of endoscopic procedures are performed. These include routine procedures such as upper gastrointestinal endoscopy, colonoscopy and sigmoidoscopy. Advanced endoscopic procedures such as pancreaticobiliary endoscopy (ERCP), endoscopic ultrasound (EUS), balloon enteroscopy and videocapsule endoscopy are also commonly performed. Currently, the unit is also performing a wide variety of ablative techniques for patients with Barrett's esophagus with either early esophageal cancer or at high risk for developing cancer. The unit offers both the broadest array of techniques and experience in the state of Virginia. Current techniques include endoscopic mucosal resection, radiofrequency ablation and cryotherapy techniques using both liquid nitrogen and carbon dioxide. Finally, several novel technologies for advanced mucosal imaging are offered including confocal microscopy (to evaluate for early dysplastic changes in Barrett's esophagus and inflammatory bowel disease) and direct cholangioscopy (to evaluate the biliary tract). 

In addition to endoscopic techniques, a number of procedures are available to assess digestive physiology as it relates to various digestive disorders. These include high resolution esophageal manometry and esophageal topography and anorectal manometry. Esophageal function can be further evaluated with esophageal pH monitoring using either a standard catheter-based electrode or an endoscopically placed radiotelemetry sensor (Bravo). Finally, non-acid reflux can be measured using multichannel intraluminal impedance testing.

Therapeutic Endoscopy

The section of advanced therapeutic endoscopy offers all advanced endoscopic procedures, including advanced endoscopic imaging (confocal endomicroscopy, narrow band imaging, chromoendoscopy), endoscopic mucosal ablation (carbon dioxide cryotherapy, radiofrequency ablation), endoscopic mucosal resection (EMR), endoluminal stenting, endoscopic ultrasonography (EUS), EUS-guided FNA, EUS-guided interventions (pseudocyst drainage, celiac plexus block, rendezvous procedures, etc.), diagnostic and therapeutic ERCP (including ampullectomy, sphincter of oddi manometry, pediatric ERCP, papillotomy, cholangioscopy).