The Rhode Island Hospital Endoscopy Unit occupies 9000 square feet on the 9th Floor of the Zecchino Pavilion (Main Building). 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 Siemens Luminos Agile DigitalFluoroscopy Unit, a scope re-processing room, which is capable of handling six 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 using ProVation®, which generates written reports with full color images and interfaces with the Lifespan system-wide electronic record Lifechart (EPIC) that provides an image and research 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. Endoscopic procedures are also performed in a separate satellite unit in the Medical Office Center, and, when necessary, in the operating room.
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 and Spyglass™ direct biliary visualization, 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 with the Olympus/Hitachi Aloka processor 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 and treatment 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. Procedures are performed with both moderate sedation and anesthesia support, as appropriate.
The Endoscopy Unit offers a number of non-endoscopic diagnostic tests, including catheter and capsule based 24-hour impedence-pH and pH studies, esophageal and anal manometry, sphincter of oddi manometry, and capsule endoscopic imaging of the small intestine. More detailed pelvic floor studies including endoanal ultrasound, manometry, and pudendal nerve latency studies are offered at the Medical Office Center satellite.
Translational research is conducted in our unit in collaboration with our academic and voluntary staff. Currently, we are involved in studies assessing H.Pylori antibiotic resistance patterns, the use of photodynamic therapy in malignant biliary strictures, and the use of cryotherapy in the treatment of Barrett’s esophagus with dysplasia and early stage esophageal cancer. Several of these studies are conducted in association with the 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.