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Gastroenterology and advanced endoscopy are areas that are constantly in development, new technologies in the field give rise to new treatments, which respectively assimilate new terms in medical terminology.
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Stones in the gallbladder
About 20% of the population has stones in the gallbladder. Stones in the gallbladder can cause pain, inflammation of the gallbladder and pancreas and the exit of stones to the main bile duct and cause jaundice. The treatment for stones in the gallbladder is surgery to remove the gallbladder, or removal of stones in the gallbladder without surgery and if a stone passes into the main bile duct, an endoscopic removal should be performed in an operation called ERCP. (Link that refers to letter B ercp check)
Laparoscopic surgery is a common technique that is done through small holes in the body (between 5-10 millimeters) which eliminates the need for open surgery and allows for a speedy recovery.
ENDOSCOPIC ULTRASOUND - EUS
ENDOSCOPIC ULTRASOUND EUS IS ONE OF THE MOST EFFECTIVE IMAGING MEASURES IN BENIGN CONDITIONS AND TUMORS OF THE GASTROINTESTINAL TRACT AND SERVES AS A DIAGNOSTIC AND THERAPEUTIC AID. IT IS POSSIBLE TO USE THIS TOOL TO ASSESS THE DEGREE OF PENETRATION OF TUMORS, THE INVOLVEMENT OF DIFFERENT LAYERS OF THE DIGESTIVE TRACT, THE INVOLVEMENT OF BLOOD VESSELS AND OTHER IMPORTANT DATA THAT WILL AFFECT MEDICAL TREATMENT. IN ADDITION, ENDOSCOPIC ULTRASOUND ALLOWS TAKING A CELL SAMPLE - NEEDLE BIOPSY (FNA) FOR THE PURPOSE OF ACCURATELY DIAGNOSING THE TYPE OF TUMOR. THE EXAMINATION IS PERFORMED ORALLY WITH THE HELP OF A FLEXIBLE OPTICAL DEVICE WITH AN ULTRASOUND TRANSDUCER AT THE END.
ULTRASOUND EXAMINATION ENDOSCOPIC EUS IS CARRIED OUT ON SUSPICION OF STONE DISEASE OF THE BILIARY TRACT, RECURRENT INFLAMMATION OF THE PANCREAS, SUSPICION OF TUMOR DISEASES OF THE BILIARY TRACT AND PANCREAS, SUSPICION OF THE PRESENCE OF SUBMUCOUS PROCESSES IN THE CAVITY OF THE GASTROINTESTINAL TRACT, FOR THE ASSESSMENT OF THE DEGREE OF PENETRATION OF TUMORS AT DIFFERENT SITES OF THE GASTROINTESTINAL TRACT, FOR THE ASSESSMENT OF THE DEGREE OF SPREAD OF TUMORS IN THE THORAX AND LUNGS, FOR THE PURPOSE OF TAKING SAMPLES FROM DIFFERENT AREAS (WITH THE AIM OF CHARACTERIZING THE NATURE OF THE DISEASE AND DISTINGUISHING BETWEEN A BENIGN PROCESS AND A MALIGNANT PROCESS).
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact Our Customer Service
Azophagitis / Esophagitis - Esophageal inflammation
Azophagitis is an inflammation that damages the tissues of the esophagus. This inflammation often causes pain during swallowing, difficulty swallowing, and chest pain. The causes of this include the return of acids from the stomach into the esophagus, ingestion of medications, infection and allergies.
Eosinophilic azophagitis
Eosinophils are white blood cells that regulate inflammation and are important at the time of allergic reactions . Eosinophilic azophagitis occurs when there is a high concentration of these white blood cells in the esophagus. This is probably due to a reaction to an allergic factor. People with eosinophilic esophagitis are allergic to various types of food.
Drug-induced azophagitis – Ingestion of pills can cause the destruction of tissues if they remain in the esophageal tissue for a long time.
Infectious azophagitis
Azophagitis can be caused by a viral, fungal infection or by a parasite in the tissues of the esophagus.
This is a relatively rare infection that affects people whose immune systems are weak, such as people with AIDS or cancer.
Achalasia / Achalasia
Disease of the sphincter between the esophagus and stomach.
A condition in which the sphincter muscle at the lower end of the esophagus does not reach relaxation and causes difficulty swallowing and raising recently eaten food. Complaints include difficulty swallowing, pain while eating, vomiting, weight loss. The treatment is endoscopic or surgical and is based on cutting the muscle (mitomy) that does not contract in the lower sphincter of the esophagus.
Endoscope / Endoscope
An advanced device made of a long, narrow and flexible tube and built of glass fibers and surrounded by a layer of plastic material. The endoscope is as thick as a finger and through it you can look into the cavity of the stomach or intestine and perform different actions at the same time. At the time of endoscopic examination, it is possible to easily adjust the end of the device inside the digestive tract. Apart from careful observation and examination, it is possible during the examination to take a tissue sample (biopsy), pump bile or gastric juice and find out the presence of an infection in the digestive tract.
For example, a straight endoscope is used to examine joints, while a flexible endoscope helps in the examination of the colon.
Endoscopy / Endoscopy
It is a general name for tests that use various endoscope instruments. The examination usually refers to an examination of the upper gastrointestinal tract, and is therefore sometimes also called gastroscopy. However, endoscopy examinations are called depending on the organ they are examining. For example, an examination of the lower gastrointestinal tract is called a colonoscopy and is performed using a colonoscope.
An endoscopy of the upper gastrointestinal tract usually involves inserting a long, flexible tube (endoscope) into the esophagus through the mouth. A tiny camera at the end of the device allows an examination of the esophagus, stomach and upper part of the small intestine (the thrush).
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ERCP TEST
THE EXAMINATION IS PERFORMED WITH THE HELP OF A FLEXIBLE DEVICE (ENDOSCOPE) THAT IS INSERTED ORALLY INTO THE DUODENUM AND REACHES THE OPENING OF THE BILE DUCT AND PANCREAS. THROUGH THE ENDOSCOPE CANAL, A PLASTIC TUBE IS INSERTED INTO THE OPENING OF THE PAPILLA AND THROUGH IT A CONTRAST AGENT IS INJECTED ON THE BASIS OF IODINE, WHICH ALLOWS (UNDER X-RAY REFLECTION) TO DEMONSTRATE THE BILE DUCTS AND PANCREAS. WITH THE HELP OF ERCP, IT IS ALSO POSSIBLE TO PERFORM THERAPEUTIC ACTIVITIES SUCH AS REMOVING STONES FROM THE BILIARY TRACT AND PANCREAS, DILATING THE NARROWING (BLOCKAGE) AND TAKING TISSUE SAMPLES (IN CASE OF SUSPECTED CANCER OR PRECANCEROUS CONDITION) AND INSERTING A STENT FOR THE PURPOSE OF DRAINING THE BILE AND PANCREAS AND KEEPING THEM OPEN, FOR EXAMPLE, IN SITUATIONS WHERE THERE IS A BLOCKAGE.
THE ERCP TEST IS A TEST THAT TAKES AN AVERAGE OF ABOUT 40 MINUTES.
The test is performed under sedation, which is given intravenously before the examination.
After receiving the sedation, a "tooth holder" will be inserted into your mouth, the purpose of which is to keep your mouth open throughout the examination.
The test is performed lying on the left side or on the abdomen. During the test, monitoring devices will be attached to your body to check your heart rate, blood pressure and respiratory activity.
During the examination, the doctor inserts the device orally and places it in the area of the papilla, which is an opening of the biliary tract and pancreas into the small intestine. Through the papilla it is possible to enter the bile ducts or pancreas for treatment, for example cleaning stones, taking a biopsy from a lump or opening a blockage.
In some cases, the patient will receive prophylactic antibiotics at the time of the operation for the purpose of preventing infection.
Laparoscopic surgery is a common technique that is done through small holes in the body (5-10 millimeters), which obviates the need for open surgery and allows for a speedy recovery.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact Our Customer Service
Diaphragmatic hernia / Hiatal hernia
A hiatal hernia is a condition in which part of the stomach is pushed upwards through the diaphragm. In the diaphragm there is a small opening (hiatus) where the esophagus passes on its way to the stomach.
Revealed when examining the causes of heartburn, chest pain or abdominal pain. Most people with diaphragmatic hernia do not feel symptoms and do not need treatment. If symptoms such as heartburn and acid that arises from the stomach to the esophagus (reflux) are recurrent, they can be treated with medication or surgery.
general information
The stomach can be pushed through this opening and cause a diaphragmatic hernia. In most cases, a small hernia does not cause problems and most people do not know that it exists. But a large diaphragmatic hernia can lead to a situation where food and acid rise back up the esophagus and cause heartburn and chest pain.
Medications can relieve symptoms but sometimes a large diaphragmatic hernia requires surgery when the hernia develops and muscles and ligaments of the area opening in the diaphragm weaken and allow part of the stomach to protrude into the thoracic cavity.
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Gases in the digestive tract / Gas flatus
Gases in the gastrointestinal tract are expressed in belching (emission of gas through the mouth) or swelling (emission of gas through the rectum). Most people produce between half a liter and a liter and a half of gas every day, emitting gases up to 14 times a day.
This is a normal natural phenomenon of the body. In most cases, the gas emission is odorless, but there are cases when an odor is emitted that is unpleasant to the environment. Also, the phenomenon of flatulence may cause bloating and abdominal pain and those who experience it a little more than the average amount may very well suffer and even feel a decrease in the quality of life. Treating gases in the digestive tract correctly and accurately may be very helpful in reducing gas, abdominal swelling and abdominal pain.
In patients aged fifty and older, the possibility of colon cancer is also usually considered. The same is true when there are previous cases of gastrointestinal cancer in the patient's family. This is especially important in cases where the patient has never undergone an examination of the colon such as sigmoidoscopy or colonoscopy (endoscopic examinations of the lower gastrointestinal tract).
Tumor / Tumor
A cluster of cells that have begun to divide in an uncontrolled manner.
A benign tumor - is a tumor whose cells do not spread to other organs of the body - but if they continue to grow in the original area and their growth can cause stress on the adjacent organs.
Malignant tumor - is cancerous in nature, consists of cells with the ability to spread. Without treatment, metastases may be sent to other areas of the body, to nearby tissues and destroy them. Sometimes cells break away from the original (primary) tumor and spread to other organs of the body, through the bloodstream or lymphatic system. When these cells reach a new area, they may continue to divide, forming new nodules called 'secondary growth' or 'metastasis'.
Symptoms of the tumor depend on its location. For example, a tumor in the lungs can cause coughing, shortness of breath, or chest pain. Intestinal tumors can cause weight loss, diarrhea, constipation, anemia, and blood in the stool.
Gastroenterology / Gastroenterology
In short, "gastro", is a field of medicine that treats diseases of the digestive system and organs of the digestive system, which include the stomach, esophagus, intestines, biliary tract and pancreas. The word gastroenterology means: gastroenterology = stomach, entero = intestines, logos = theory.
Gastroenterology has made huge strides and developed technologically mainly in terms of surgeries and advanced diagnostic methods. Among the tests offered in gastroenterology institutes are colonoscopy, gastroscopy, sigmoidoscopy and more. If it was once necessary to "open the abdomen" in every surgery, today most medical procedures are performed in minimally invasive surgeries using an endoscope.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
Gastroscopy / Gastroscopy
(or endoscopy of the upper gastrointestinal tract) using advanced endoscopy
Is an examination used to observe the esophagus in the stomach and duodenum (the first part of the small intestine). The test is performed by inserting an endoscope into the patient's mouth. The endoscope is a flexible tube with a diameter of about 1 cm, which contains a light source and a camera.
Inside the endoscope there are working channels that allow pumping, injecting air and water and transferring instruments for various treatments. The endoscope allows, if necessary, the use of additional equipment, for example for taking a biopsy or performing a resection of a polyp during the examination.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
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SAMPLING OF SIGNALS USING A THIN NEEDLE - FNA
TAKING SAMPLES FROM SUSPECTED TISSUE IN THE GASTROINTESTINAL TRACT AND ADJACENT ORGANS IN AN ENDOSCOPIC WAY UNDER THE GUIDANCE OF A SYSTEM ON SOUND ACCOMPANYING THE ENDOSCOPE (EUS).
The method allows access to many organs in the body, at the same time as assessing the spread of the malignant disease for the purpose of planning surgeries and treatment methods.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
Dyspepsia/ Dyspepsia
Also called functional dyspepsia, is a disorder of the digestive system, manifested in the upper part of the abdomen in a complex of symptoms called dyspeptic symptoms: feeling of bloating, flatulence, constipation or diarrhea, feeling of early satiety and fullness regardless of the size of the meal, belching, burning sensation, nausea, vomiting, etc.
Rectal bleeding- Rectal Bleeding
Rectal bleeding also called blood in the stool is the secretion of fresh bright red blood through the anus. The amount of secretion can be small or large.
In any case of the appearance of bleeding in the stool, the bleeding, its duration, frequency and degree of severity should be monitored. When the bleeding lengthens and involves the loss of significant amounts of blood, it is a potentially life-threatening condition and the attending physician should be contacted for examination and adjustment of treatment.
Blood can be seen in the feces, in the toilet or on the toilet paper and light bleeding is manifested in individual drops of fresh, red blood.
When bleeding is accompanied by pain, this is usually a sign that the source of the problem is in the anus.
Symptoms are secretion from the anus of red or red-brown blood and blood clots.
The shade of blood in the stool depends mainly on the area where the bleeding is located in the gastrointestinal tract. The closer the bleeding area is to the anus, the more bright red the blood will be. Therefore, bleeding from the rectum, anus, and lower part of the large intestine tends to have a strong red color, while bleeding originating in the first parts of the large intestine – the right or transverse colon – is usually characterized by a dark red or brown tint. In bleeding from the upper gastrointestinal tract, the color of the stool will be brown or black.
The common causes of this type of bleeding can be divided into groups:
• Diseases of the rectum and rectum area - such as, hemorrhoidal fissures and ulcers.
• There may be slight rectal bleeding due to constipation and the passage of hard stools through the anus.
• Anatomical (structural) problems - mainly from the presence of "pockets" (called sections or diverticulosis) in the large intestine that cause problems in the blood supply to the intestine (ischemia).
• Tumors like colon cancer.
• Inflammation of the intestine - for example due to infection or exposure to radiation - as well as inflammatory diseases such as Crohn's disease and ulcerative colitis.
• After invasive operations such as a colonoscopy during which polyps were excised or a biopsy was taken.
• Abnormal superficial blood vessels in the intestinal wall (angiodysplasia)
• After radiation therapy to the pelvis due to malignancy, for example in the prostate gland.
Esophageal inflammation due to reflux
Reflux is a condition in which the contents of the stomach return from the stomach to the esophagus. This disease called Gastroesophageal reflux-GERD is a condition in which the return of the acidity of the stomach is an ongoing problem condition. As a result, the tissues in the esophagus are damaged and chronic inflammation is caused.
Fecal occult blood / Occult Blood Screen
A simple and recommended test for the diagnosis of colon cancer. In the case of a positive result of latent blood in the stool, it may indicate the presence of polyps since polyps and cancer tend to bleed. It may take many years for a polyp to develop into cancer. Although since a long time elapses from the formation of the polyp until it becomes cancer, there is a long time interval that allows early detection of colon cancer and most often the patient will be referred for a colonoscopy.
Defecography - Emptying photography
Defecography is an X-ray examination that allows to see the rectum and evaluate its functioning. The examination can detect internal prolapse of the pelvic organs and checks the motility of the anus and rectum. The examination is performed during a bowel movement in real time and allows the doctor to evaluate the functioning of the pelvic floor and rectum muscles.
The purpose of the examination is to examine situations of chronic constipation or rectal prolapse. It is performed when there are complaints of incontinence of the anus and enzymus (excessive contraction of the anus) and in other situations of dysfunction.
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Esophageal stenosis
Damage to the cells in the lower part of the esophagus as a result of exposure to gastric acids leads to a change in the tissues of the esophagus. As a result, esophageal stenosis occurred, resulting in difficulty swallowing.
(DISEASE) VASHTI/GERD REIMBURSEMENT
GASTROESOPHAGEAL REFLUX DISEASE (GERD), ALSO KNOWN AS REFLUX, IS ACTUALLY A DISEASE THAT AFFECTS THE LOWER ESOPHAGEAL GATEKEEPER, WHO IS RESPONSIBLE FOR PREVENTING THE RETURN OF GASTRIC CONTENTS TO THE ESOPHAGUS. THE SEVERITY OF THE DISEASE IS DETERMINED BY THE DEGREE OF IMPAIRMENT OF FUNCTION, THE TYPE OF FLUID THAT RETURNS FROM THE STOMACH TO THE ESOPHAGUS AND THE DEGREE OF NEUTRALIZING EFFECT OF SALIVA.
When the digestion process is normal, with the movement of food down the esophagus to the stomach, the lower esophageal gatekeeper opens to allow the food to enter the stomach, and closes immediately afterwards to prevent the contents of the stomach from rising back into the esophagus. Various processes in the body cause the gatekeeper to weaken and loosen, resulting in the return of food, with or without gastric acids or bile from the stomach to the esophagus. These cause irritation of the esophageal sheath and cause the disease of the esophageal reflux.
THE SYMPTOMS OF ESOPHAGEAL REFLUX MAINLY INCLUDE REFLUX AND HEARTBURN. BOTH ARE GASTROINTESTINAL DISEASES IN THEMSELVES, AND ARE COMMON IN THEIR TEMPORARY APPEARANCE IN MOST PEOPLE. IF THESE SYMPTOMS APPEAR MORE THAN TWICE A WEEK, OR INTERFERE WITH THE DAILY ROUTINE, THEY ARE OFTEN DIAGNOSED AS GERD.
A persistent state of return of stomach acids to the esophagus can irritate the tissues of the esophagus and turn them into assophageals. Chronic inflammation of the esophagus can lead to complications such as esophageal ulcer (gastric acids can severely erode the tissues of the esophagus and cause open-ulcer wounds; these ulcers can bleed, cause pain and difficulty swallowing).
Barrett's esophagus is a condition in which the color and texture of the esophagus tissues change. These changes lead to an increase in the chances of developing esophageal cancer. In such a case, the doctor may recommend performing a gastroscopy.
In order to diagnose whether you have had esophageal reflux syndrome, the doctor can recommend tests such as:
X-ray of the upper gastrointestinal tract is sometimes called barium. In this examination, one should drink a liquid that coats and fills the cavities in the digestive tract. Then an x-ray of the upper gastrointestinal tract is performed. Because of drinking the liquid the doctor can see the shape of the upper digestive tract.
Helicobacter pylori – Helicobacter pylori
A bacterium found in the stomach. Exists in about 60% of the population in Israel. The infection is from person to person (through saliva). Usually does not cause problems and does not need to be treated. It can sometimes cause symptoms of abdominal pain, nausea, stomach or thrush ulcers, and rarely stomach cancer.
Treatment with Helicobacter pylori includes a combination of several types of antibiotics and an antacid preparation and there are studies that offer a combination of probiotics alongside drug therapy.
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Esophagitis – Esophagitis
It is a tube 20-25 cm long, through which food passes by pushing the esophageal muscles from the pharynx to the stomach. The location of the esophagus is behind the trachea and is located basically in part of the length of the neck down towards the chest.
When the functioning of the esophagus is disrupted, various medical problems are caused. Among the common medical problems that concern the esophageal tube is a problem in the lower or upper sphincter of the esophagus. Also problems in the esophagus include narrowing of the esophagus inflammatory, a flat esophageal ring in the lower part of the esophagus. The same goes for disruption of the esophageal muscles when swallowed, tumors that interfere with swallowing and the activity of the esophagus. Likewise, the destruction of the esophageal lining due to gastric-esophageal reflux is also a relevant problem. Gastroesophageal reflux Reflux Disease is a disorder during which acidic fluid rises from the stomach up the esophagus. Reflux will cause a feeling of heartburn in the chest, inflammation and burning in the throat. Reflux damages the esophagus, creates wounds in it and damages the esophageal pads. Reflux disorder is caused by the problem of the lower esophageal sphincter, bacteria, diaphragmatic hernia and more.
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Hemorrhoids/ Hemorrhoids
Hemorrhoids are natural blood vessels of the anus that protrude outwards, usually due to chronic constipation. In women is characteristic after pregnancies and births. Usually does not cause complaints. Can cause pain or bleeding. The treatment is the treatment of constipation, local drug treatment and rarely a hemorrhoid surgery or hemorrhoid removal should be performed.
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Liver - Drug Damage Induced Liver Injury (DILI)
Liver damage from the use of medication is an acute problem that can cause mortality. In the U.S., it is the most common cause of acute liver failure, which is only followed by 600 liver transplants per year.
Peptic ulcer / Peptic Ulcer
It is actually a wound in the gastric or duodenal mucosa. The ulcer is formed when the natural protection of the intestinal mucosa is impaired. The ulcers are more common in smokers and patients taking NSAIDs (non-steroidal anti-inflammatories such as: aspirin, voltaren, nurofen, etc.).
Gastric ulcer/thrush (ulcer)
A wound that occurs in the stomach or thrush. May cause abdominal pain, bleeding and rarely a hole in the stomach or thrush. Usually caused due to the bacterium Helicobacter pylori however also caused due to medications such as aspirin, smoking or alcohol.
COMPLEX POLYP RESECTION (EMR)
Polyps are small lumps that grow into the small intestine, large intestine, stomach, esophagus, and other organs. There is a great variety of polyps and some of them can even develop into cancerous tumors.
The larger the surface area of the polyp, the more complex its resection will be. One of the innovative methods of excision of large polyps is through endoscopic bean resection, which replaces the surgery in some cases. In this technique, a liquid, such as saline, is used, which is injected under the polyp in order to elevate and isolate it from the surrounding tissue.
DR. Vosko PAINTS POLYPS REMOVAL USING INNOVATIVE EQUIPMENT, STATE-OF-THE-ART KNIVES, ADVANCED TECHNOLOGY, OPTIMAL AND ENLARGED VISIBILITY IN HD, AND A COMBINATION OF MANY YEARS OF EXPERIENCE AND SKILL INCREASE THE CHANCES OF REMOVING THE POLYP OR LESION IN ITS ENTIRETY ALONGSIDE A HIGHER AND FASTER CHANCE OF RECOVERY.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
EXCISION OF TUMORS IN THE GASTROINTESTINAL TRACT WITHOUT SURGERY USING A NEW METHOD – ESD
Acacia was born in Japan in the early 2000s as a method of removing gastric tumors at earlier stages and endoscopically. In the past decade, the system has also spread to Western countries and has recently reached Israel as well.
Most cancerous tumors in the gastrointestinal tract start from precancerous lesions that develop in the most superficial layer of the digestive wall - the mucosa . As the tumor grows, it begins to penetrate the deeper layers of the intestinal wall and from there it may spread to nearby lymph nodes and send metastases to more distant areas of the body.
The usual treatment for these pre-malignant lesions is resection through endoscopic action.
THE ADVANTAGES OF THE METHOD COMPARED TO OTHER RESECTION METHODS SUCH AS EMR, ARE THAT LESIONS OF ANY SIZE CAN BE EXCISED IN ONE PIECE, WHICH ALLOWS A GOOD PATHOLOGICAL EXAMINATION OF THE FINDING AND AN ACCURATE ASSESSMENT OF THE RISK OF SENDING METASTASES TO THE LYMPH NODES ACCORDING TO THE DEGREE OF PENETRATION OF THE TUMOR INTO THE SUBMUCOSA.
All operations involved in this method are done under anesthesia or sedation, through an endoscope inserted from the mouth or anus and without surgical surgery.
Initially, the tumor boundaries are marked through the endoscope and then a liquid is injected under the tumor directly into the submucous layer, so that it is possible to separate the tumor from the deeper layers of the wall. After making a peripheral incision around the tumor area, Dr. Wasko will perform a cut of the submucosa using a special knife that will separate the tumor from the surrounding tissues. After the tumor is removed in its entirety, it will be sent for laboratory pathological examination.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
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Pancreas – increase in pancreas enzymes
The pancreas is a gland located between the stomach and the small intestine and which secretes enzymes that participate in the process of digestion. In addition, the pancreas produces hormones such as insulin.
Inflammatory pancreas / pancreatitis
Can be acute (not permanent) or chronic (permanent or intermittent for a long time).
Chronic inflammation of the pancreas manifests itself in recurrent seizures that eventually cause scarring of the pancreas, pain, disturbances in blood sugar levels and diarrhea.
Inflammation of the pancreas can be of varying degrees of severity: from mild inflammation to severe and life-threatening inflammation.
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CHOLESTHETIC LIVER DISEASE (PSC-PBC)
PRIMARY BILIARY CIRRHOSIS (PBC) – INFLAMMATION OF THE PORTAL SPACES AND NARCOSIS OF THE INTRAHEPATIC BILIARY TRACT. PSC IS A CHRONIC CHOLESTATIC DISEASE CHARACTERIZED BY INFLAMMATION, OBSTRUCTION AND FIBROSIS OF THE INTRA AND EXTRAPYRAMIDAL BILIARY TRACT.
Metabolic Liver Disease / Metabolic Liver Disease
Metabolic conditions involving the liver and can cause chronic liver disease, cirrhosis and cancer.
Sectional disease / diverticulosis
Sections are "pockets" that depart from the wall of the large intestine and protrude through weak points in the large intestine. Each such pocket is referred to as a 'section' (diverticula).
About half of the population in the Western world is between the ages of 60 and 80, and almost all people over the age of 80 suffer from sectional disease.
When the pockets become infected or become inflamed, the problem is referred to as diverticulitis. The incidence of the onset of inflammation is 10%-25% of cases of sectional disease.
. Very common at older ages in the Western world. Can cause abdominal pain and constipation. Sometimes the sections also cause bleeding, inflammation or puncture of the intestinal wall. Treatment of symptoms by drug therapy for constipation or abdominal pain. If there are complications, surgery should be performed to remove part of the intestine with the sections.
Overweight / Overweight
Obesity is defined as storing more fat than desired to an extent that may cause morbidity or aggravate an existing disease. The most common measure for assessing obesity and its severity is the Body Mass Index (BMI). This indicator is calculated according to the ratio of height to weight squared.
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HOWEVER, BMI DOES NOT PREDICT EVERYTHING. WHEN ASSESSING A LINK BETWEEN OBESITY AND MORBIDITY, WE MUST TAKE INTO ACCOUNT CHRONIC DISEASES, AGE, FAMILY HISTORY, EATING HABITS, TYPE OF OBESITY, AND MORE.
Through this measure, it is possible to learn whether the person is at a normal weight, underweight, overweight or obese.
The indicator is calculated as follows: weight (in kilograms) divided by height squared (in meters).
HELEN TABLE OF BMI VALUES AND WEIGHT RATINGS:
Up to 18.5 – underweight and at risk of malnutrition.
5-24.9 Normal weight and relatively low risk of obesity-related diseases.
25-29.9 Overweight.
30-34.9 – GRADE I OBESITY.
35-39.9 – GRADE II OBESITY.
40 AND ABOVE – GRADE III OBESITY.
THUS OVERWEIGHT IS A CONDITION IN WHICH THE SUBJECT'S BMI RANGES FROM 25-29.9
The recommended solution before bariatic surgery is to contact a dietitian so that she can provide an initial response by changing the diet, diagnosing blood test results and guidance on recommended foods and sports activities in order to allow for a real and prolonged change.
In extreme cases, additional treatments may help and include medication, endoscopic treatment, or bariatric surgery.
Jenny Vosko, a clinical nutritionist, expert in gastroenterology nutrition, diabetes nutrition and accompanies patients for over a decade after endoscopic treatments and she provides them with knowledge, tools and methods for proper and healthy eating that will enhance the effect of the treatment and help maintain it for years to come.
To schedule a consultation you can contact our customer service
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(test) to monitor the acidity of the esophagus
In this test, a device is used that measures when the acid rises in the esophagus and for how long. During the examination, a catheter is inserted - a thin and flexible tube - through the nose into the esophagus. During the examination, the catheter remains in place and is connected to a small computer that is located on the patient's housings.
Esophageal motility test - This test checks the pressure and motility of the esophagus and is performed by inserting a catheter through the nose that reaches the esophagus.
Treatment for heartburn and other symptoms of esophageal reflux syndrome usually begins with over-the-counter acid-controlled medications. In cases where there is no relief of symptoms and after a few weeks the doctor can recommend stronger medicines and sometimes even surgery.
Starting this January, Dr. Vosko will begin performing Transoral Incisionless Fundoplication (TIF), an innovative treatment of its kind in Israel that will address the gap between drug therapy and surgical surgery. TIF is a minimally invasive, endoscopic procedure, much safer compared to surgery, with faster recovery time for patients, and all this with amazing clinical results.
To schedule a test appointment you can contact our customer service
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Sigmoidoscopy
Sigmoidoscopy is a short colonoscopy that advances in the last 60 cm of the colon cavity, the examination is designed to diagnose and treat various diseases relevant to the area in question, the examination is performed by inserting an endoscope at the end of which is a camera with advanced optical capabilities and high resolutions, the camera transmits the image to Dr. Vosko's screen, through which he monitors the findings and steers the endoscope according to needs, the test is relevant for bleeding in the anus, Changes in the nature of bowel movements, monitoring inflammatory bowel disease and more. The test makes it possible to identify tumors at an early stage, the length of the examination is relatively short and should not last more than 15 minutes
Pancreatic cancer / Pancreatic cancer
There are about 20 different types of pancreatic tumors. Most pancreatic cancers originate in the pancreatic duct. These cancers are usually adenocarcinomas (cancers that originate in the glands). As cancer grows, it can spread to nearby organs (like the stomach and blood vessels) or distant organs (like lungs and liver). Although pancreatic cancer is relatively uncommon, it is nevertheless the fourth deadliest of all cancers.
Colon Cancer / Colorectal Cancer
Cancer (malignancy) originating from the colon. Can cause abdominal pain, weight loss, changes in bowel habits, bleeding from the anus. However, it can also be discovered without any complaints from the patient. The test of choice to detect it is a colonoscopy.
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Constipation/ constipation
Difficulty in passing feces out of the intestine. May be due to slow intestinal transit, rectal problem or secondary to medication or systemic diseases (Parkinson's, severe diabetes and others). The treatment is pharmacological.
Constipation is a common gastroenterological problem.constipation is defined as two or fewer bowel movements per week or as a great difficulty and effort when emptying. Among the general population, the normal frequency of bowel movements is defined as between 3-12 bowel movements per week. There is a widespread misconception among the public that the normal frequency of bowel movements is one exit per day. This concept leads to excessive and sometimes even dangerous use of laxatives.
People who suffer from this sometimes experience difficulties during the transfer of feces and this process is accompanied by pain and exertion. Fortunately, most cases of constipation are temporary. A slight lifestyle change like exercise and a diet rich in dietary fiber will often alleviate constipation.
Complaints and signs:
Hard stools
The number of bowel movements per week is less than 3
Excessive effort during bowel movements
Feeling of "rectal obstruction"
Feeling that you have not been fully emptied after a bowel movement
In a normal state the feces are pushed in the intestine by muscle contraction. In the large intestine, most of the water and salt found in the feces mixes and is absorbed again because it is essential for the body. Despite this when the intestine absorbs a large amount of water or if the contraction of the muscles is slow, the stool becomes hard and dry and passes through the intestine very slowly. This is the main cause of constipation. Another cause of constipation is when muscles used during bowel movements are not "coordinated" properly. This problem is called "pelvic floor dysfunction" and it causes exertion in every bowel movement.
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Polyp/ Polyp
A polyp is a benign (non-cancerous) tumor in the gastrointestinal tract. There are several types of polyps. A polyp called adenoma can develop into cancer. Polyps as if they can be found throughout the digestive tract but are more common in the large intestine. Statistics show that 20-50% of the population over the age of 50 will have polyps in the colon.
Colon Polyp / Polyp colon
A polyp is a lesion of the mucosa of the large intestine, a protrusion consisting of the accumulation of cells that cover the intestinal cavity. Although most polyps are not a medical problem, some can become malignant over time. Anyone can develop a polyp in the large intestine, but the risk increases beyond the age of 50. People who are overweight, smokers, have a high-fat diet or have a family background are at increased risk.
Polyps are formed as a result of abnormal growth of cells that make up the tissue of the large intestine. Healthy cells grow regularly, in a process that is regulated by several groups of genes.
A mutation, a growth process that is abnormal, in one of the genes can cause cells to grow in an uncontrolled manner.
As a result of this uncontrolled growth, polyps form and can develop throughout the colon.
Fissure / Anal Fissure
A fissure is a rupture of the muscle of the anus. Caused due to chronic constipation.
Causes pain and bleeding from the anus. The treatment is to prevent constipation, and local medication to relieve pain or surgical treatment.
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Celiac disease / Celiac disease / Celiac
In the past, it was also called the celiac disease, which is characterized by sensitivity to the gluten and protein of cereals. Can be diagnosed at any age. The complaints can be of abdominal pain, diarrhea, iron deficiency anemia, premature calcium incontinence and much more. The diagnosis is made in a combination of a blood test (serology) and a biopsy from the duodenum that is taken in a gastroscopy examination.
Heartburn / Heartburn
A burning sensation accompanied by burning pain in the chest area, behind the sternum and in the throat. Sometimes the burning sensation can continue to the neck and reach the mouth.
Symptoms usually appear after eating, but can also occur at night. Lying down or leaning forward may worsen symptoms.
Being overweight, pregnant, following a high-fat diet, eating at night, and smoking increase the risk of heartburn. Usually a change in lifestyle will eliminate the unpleasant feeling.
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Colonoscopy /Colonoscopy
Examination of colonoscopy of the colon with the help of fiber optics. Performed after taking a laxative to cleanse the intestine and provide sedation during the examination. This test has been proven to save lives and prevent colon cancer. It is recommended for anyone over the age of 45 for early detection of colon cancer.
Colonoscopy using advanced endoscopy
The test is performed for the diagnosis and treatment of diseases of the lower digestive system that includes the large intestine and the far end of the small intestine.
The colonoscope is a thin, flexible tube, with a diameter of 11 mm that includes a tiny video camera at the end. It is inserted through the rectum and allows direct observation of the large intestine and the far end of the small intestine as well as performing actions such as taking biopsies, excision of small tumors and polyps, injection, and burning to stop bleeding and expand stenosis. From this it can be understood that the guarantee of the success of these operations involves full and precise adherence to the preparatory instructions in order to arrive at the examination with a clean colon without feces.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
Crohn's disease / Crohn's disease
Chronic inflammatory disease of the intestine. Can damage all parts of the digestive system from the esophagus to the anus.
Crohn's disease causes inflammation of the gastrointestinal tract, the disease can damage any part of the digestive system: esophagus, stomach, small intestine and large intestine but is most common in the lower part of the small intestine (ileum), where the absorption of food is carried out. In this disease, the injury is to the depth of all layers of the intestine.the common symptoms are diarrhea, abdominal pain, cramps, nausea, vomiting, bloody stools, fatigue and weakness, fever, purulent secretions from the anus due to abscesses and more, which vary from person to person and depend on the severity of the disease. Daily medication may relieve symptoms but sometimes the condition may also require surgical treatment.
Ulcerative colitis
Inflammation of the colon (colon). It can be caused by an infectious agent (virus or bacteria) or by an inflammatory process that the body directs towards itself (ulcerative colitis).
It is an inflammatory bowel disease (IBD) in which inflammation develops in the lining of the colon – the inner wall that lines the intestinal cavity (this is in contrast to Crohn's disease, which can develop in all layers of the intestinal wall – from the mucosa to the seroa, its outer membrane). Colitis can involve all or part of the colon, but will always involve the rectum.
This is a chronic disease that is characterized by flare-ups and remissions over the years and usually requires regular drug treatment. Usually it is diagnosed in the third or sixth decade of life. In recent years, the disease has been on the rise in Western countries. There are about 21,000 colitis patients in Israel.
According to one theory of the development of the disease, the immune system treats the beneficial gut bacteria that invade the body and produces an inflammatory response against them. Alternatively, it may respond excessively to foreign factors (pathogens) in the intestine and thus creates persistent inflammation without control. Therefore, some of the drugs given to patients are for suppressing the immune system.
Colon capsule - A capsule test for the colon is performed using a video capsule that is similar in size to a vitamin pill and is easily swallowed thanks to a special smoothing coating. The video capsule has its own camera and light source. As the capsule makes its way through the digestive tract, images are sent to the belt placed on the patient's waist and to the portable receiver. After the examination, the doctor will watch the film and diagnose the findings. Read more about capsule test for colon.
Crohn's / Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, the disease can damage any part of the digestive system: esophagus, stomach, small intestine and large intestine but is most common in the lower part of the small intestine (ileum terminal ileum), where the absorption of food is carried out. In this disease, the injury is to the depth of all layers of the intestine, from the mucosa (the lining of the intestine) to the serosis (the outer membrane of the intestine).
Crohn's disease (as well as ulcerative colitis) belongs to the family of inflammatory diseases of the intestine (in English: inflammatory bowel diseases).
These diseases are characterized by the existence of chronic inflammation that damages the mucosa of the gastrointestinal tract. The inflammation is caused by an overabundance of the immune system – the immune system secretes inflammatory substances that damage the intestinal mucosa.
Common symptoms of the disease are abdominal pain (usually in the lower right part of the abdomen), bothersome diarrhea, general malaise, weight loss, cramps, nausea, vomiting, bloody stools, fatigue and weakness, diarrhea, fever, purulent secretions and bleeding from the anus due to abscesses, impaired nutritional status, delayed physical development in adolescents and more that vary from person to person and depend on the severity of the disease.
Daily medication may relieve symptoms but sometimes the condition may also require surgical treatment.
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Reflux / Esophageal Reflux
Return of acid from the stomach to the esophagus. Causes of heartburn, pain in swallowing, chronic cough.
Gastroesophageal reflux (GERD, esophageal reflux) is a disorder in which acidic content, which normally remains in the stomach, rises from the stomach to the esophagus and causes a burn in the inner shell of the esophagus (a tube connecting the mouth to the stomach). Sometimes the gastric juices may even go up to the throat and oral cavity.
Reflux means to flow back or forth. Gastroesophageal reflux is a condition in which what is in the stomach returns to the esophagus.
In proper digestion, the lower sphincter of the esophagus opens to allow food to enter the stomach. It is then closed to prevent food and acidic gastric juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the lower sphincter of the esophagus is weak or loosened when it should not occur.
The increase of the acidic content up the esophagus causes various symptoms that impair the patient's quality of life, including heartburn. In addition, the burn caused by the acidic content can cause long-term damage.
Gastroesophageal reflux disease, arises from a dysfunction of the muscle ring between the esophagus and the stomach. This ring is called the lower esophageal sphincter .
Reflux symptoms can be alleviated through changes in diet and lifestyle. But some people may need medication or surgery.
Risk factors for reflux
MORE THAN 25% OF THE POPULATION IN ISRAEL SUFFERS FROM HEARTBURN AT LEAST ONCE A MONTH, AND MORE THAN 5% OF ADULTS SUFFER FROM HEARTBURN EVERY DAY, INCLUDING MANY PREGNANT WOMEN. RECENT STUDIES SHOW THAT GERD IN INFANTS AND CHILDREN IS MORE COMMON THAN DOCTORS THOUGHT. THIS CAN CAUSE VOMITING THAT HAPPENS AGAIN AND AGAIN. IT CAN ALSO CAUSE COUGHING AND OTHER BREATHING PROBLEMS.
Some doctors believe that a diaphragmatic hernia may weaken the lower sphincter of the esophagus and increase the chances of gastroesophageal reflux. A diaphragmatic hernia occurs when the upper part of the stomach ascends to the chest through a small opening in the diaphragm (diaphragmatic break). The diaphragm is the muscle that separates the abdomen from the chest.
Recent studies show that the opening in the diaphragm helps to support the lower end of the esophagus.
Importantly, there are many people with diaphragmatic hernia who will not suffer from heartburn or reflux. But a diaphragmatic hernia may allow the contents of the stomach to leak more easily into the esophagus.
Coughing, vomiting, exertion or sudden physical exertion can increase the pressure in the abdomen and lead to a diaphragmatic hernia. Many healthy people aged 50 and older have a small diaphragmatic hernia, although it is usually a condition of middle age, hiatal hernias affect people of all ages.
Diaphragmatic hernias usually do not need treatment. But this may be necessary if the hernia is in danger of suffocation, or deformed in a way that cuts off the blood supply. It may be necessary to treat the hernia if you additionally have severe reflux or inflammation
. A few other things can increase the likelihood that you will have reflux:
Overweight or obesity Pregnancy Late emptying of the stomach, connective tissue diseases such as rheumatoid arthritis, scleroderma or lupus choices in diet and lifestyle can aggravate the acid reflux if you already have it: smoking certain foods and drinks, including chocolate and fatty or fried foods, coffee and alcohol large meals eating before bedtime, certain medications, including aspirin.
The most common symptom of reflux is heartburn. It usually feels like a burning pain in the chest that starts behind your sternum and moves upwards to your neck and throat. Many people say that it feels like the food is coming back here, leaving an acidic or bitter taste.
The burn, stress or pain of heartburn can last up to two hours. Often it is worse after eating. Lying down or bending down can also cause heartburn. Many people feel better if they stand upright or take an antacid that cleans acid out of the esophagus. People sometimes mistake heartburn pains for the pain of heart disease or heart attack, but there are differences. Exercise can aggravate the pain in heart disease, and rest may relieve it. Heartburn pain is less likely to go along with exercise. But you may not notice the difference, so immediately seek medical help if you have chest pain. Besides pain, you may also have nausea Bad breath Difficulty breathing Difficulty swallowing vomiting Tooth enamel erosion Lump in the throat If you have acid reflux at night, you may also have: Persistent cough Inflammation of the throat Asthma that occurs suddenly or worsens sleep problems
In addition to heartburn you may suffer from:
Nausea
Bad breath
Difficulty breathing
Difficulty swallowing
Vomiting
Tooth enamel erosion
A lump in the throat
Persistent cough
Strep throat
Asthma that occurs suddenly or worsens
Sleep problems
Transoral Incisionless Fundoplication (TIF)- an innovative treatment for reflux!
Gastroesophageal reflux disease is a very common condition among the large population. Symptoms of heartburn or regurgitation (increase in gastric contents to the esophagus and pharynx) were reported in 25% of patients in developed countries each year. Although drug therapy provides a solution for a significant number of patients, a significant number of people (ranging from 10% to 40% of patients) may fail to achieve a complete resolution of the symptoms.
Given the significant impact of symptomatic reflux disease on the quality of life, alongside the high costs and growing awareness of the possible negative effects of long-term pill therapy.
Now, after years of waiting, we are proud to be at the forefront of medical technological innovation and to bring to patients in Israel the message of Transoral Incisionless Fundoplication (TIF)
TIF IS A MINIMALLY INVASIVE, ENDOSCOPIC PROCEDURE, MUCH SAFER COMPARED TO SURGERY, WITH FASTER RECOVERY TIME FOR PATIENTS, AND ALL THIS WITH AMAZING CLINICAL RESULTS.
MULTIPLE INTERNATIONAL STUDIES HAVE SHOWN THAT THE TIF PROCEDURE IS PERFORMED SUCCESSFULLY IN UP TO 99% OF PATIENTS, WITH ONLY 2% EXPERIENCING PROBLEMS DURING OR AFTER THE PROCEDURE, SUCH AS RUPTURE OR INTERNAL BLEEDING. FOR A LARGE NUMBER OF PATIENTS, TIF PROVIDES SIGNIFICANT RELIEF OF SYMPTOMS OF REFLUX AND AN IMPROVEMENT IN THE QUALITY OF LIFE. THE MAJORITY OF PATIENTS (91%) ALSO EXPERIENCE A REDUCTION IN DIAPHRAGMATIC HERNIA AND MANY (89%) ARE ABLE TO STOP TAKING MEDICATION. WHEN REFLUX SYMPTOMS RECUR.
IF YOU COMPARE TO ISRAEL, IT MEANS THAT ABOUT 250,000 TO 500,000 PEOPLE ARE POTENTIAL CANDIDATES FOR TIF ENDOSCOPIC TREATMENT FOR REFLUX, WHICH CAN SIGNIFICANTLY IMPROVE THEIR QUALITY OF LIFE, AND WEAN OFF REGULAR DRUG THERAPY.
Dr. Sergei Vosko is the founder of the Department of Advanced Endoscopic Resections at the Shamir Medical Center (Assaf Harofeh Hospital). Performs tests, treatments and surgeries using advanced endoscopy and artificial intelligence.
To schedule a test, please contact our customer service
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Diarrhea / Diarrhea
Diarrhea - transfer of liquid stools several times a day. May be caused due to poor diet, bacterial, viral infection, gastrointestinal infections, diseases outside the gastrointestinal tract, medications and emotional stress.
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Irritable bowel syndrome / IBS - Irritable Bowel Syndrome
It is a syndrome and not a disease. Those who suffer from it may complain of a wide range of complaints such as abdominal pain, excessive gas, constipation, diarrhea, bloating and nausea. Usually caused by emotional background (stress, stress and/or anxiety). The treatment is pharmacological, dietetic, and sometimes mental.
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