DEPARTMENT OF GASTROINTESTINAL SCIENCES
Gastrointestinal Sciences has been one of the fastest growing specialities in the last ten years. The impact is in terms of diagnosing and treating complex gastrointestinal problems using advanced technology such as High Definition Endoscopes, Narrow Band Imaging (NBI), Endoscopic Ultrasound, Spy-Glass Technology, Fibro Scan, etc.
Treatment & Procedures
Experienced Gastroenterologists and Liver specialists, who deal with diagnosis, perform various endoscopic procedures, including high end therapeutic procedures which not only helps in diagnosis but offers treatment at the same time. This specialty offers the advantages of quick recovery, minimum hospital stay and reduced cost. The Gastroenterology & Hepatology Department at Manipal Hospitals offers comprehensive care for patients with gastrointestinal, liver and pancreatic disorders. The team includes skilled Gastroenterologists, Endoscopists, Gastrointestinal Surgeons, Oncologists and Radiologists. The unit is very well equipped with full fledged diagnostic and therapeutic video endoscopes. It also has capsule endoscopy and endoscopic ultrasound. Manometry, the measurement of pressure along various parts of the gastrointestinal tract, will be introduced shortly. Another diagnostic measure which the department is plannig to introduce is the breath test.
Minimally Invasive Interventional Gastroenterology
This medical wing comprises of experienced Gastroenterologists and Liver specialists, who deal with diagnosis, perform various endoscopic procedures including high end therapeutic procedures which not only helps in diagnosis but offers treatment at the same time. This specialty offers the advantages of quick recovery, minimum hospital stay and reduced cost. This treatment is mainly done for patients with Gastrointestinal Bleeding, Bile Duct Stones, and patients with Pancreatitis and its complications (Pseudocyst). This type of endoscopic intervention treatment is also done for patients with various cancers affecting the gastrointestinal tract (placing stents across blocks in the stomach, oesophagus and colon etc) and also for cancers involving the bile duct, gall bladder and pancreas causing obstruction to the flow of bile. More than 50 percent of these patients with cancers affecting the pancreas, gall bladder or bile duct actually have tumours which are unresectable for cure and high end endoscopic procedure offers them the best/ least invasive treatment.
The department is equipped to handle the following:
- Chronic Liver Diseases and its complications
- Oesophageal Disorders (cancerous and benign)
- Gastric Disorders like Peptic Ulcer and Cancer
- Colorectal Diseases and Cancer
- Inflammatory Bowel Diseases
- Ulcerative Colitis and Crohn’s Disease
- Abdominal Tuberculosis and others
- To offer and carry out treatment for all Gastrointestinal, Liver, Biliary and Pancreatic Disorders along with Gastrointestinal Cancer with highest standards of ethics, competence and safety.
- We ensure safety standards for all Gastrointestinal Endoscopic Intervention with state-of-the-art technology and ensuring disinfection of endoscope and its accessories with international guidelines/standards.
- To acquire and perform all advanced therapeutic endoscopy, state-of-the-art Gastrointestinal Interventions with utmost ethics, skills and expertise.
This department helps address diseases that affect the gastrointestinal, pancreatic, biliary tract and liver and gall bladder problems under one roof, medical and surgical. A patient coming gets evaluated by a team comprising of Gastroenterologist and the Surgical Team together. A comprehensive treatment is offered since some of the patients might require only endoscopic therapy (without surgery) or might actually require surgical interventions.
The Department of Surgical Gastroenterology
The Department of Surgical Gastroenterology is a referral centre for a variety of complex hepatobiliary tumours and benign diseases, pancreatic diseases and gastrointestinal surgical problems. The department is equipped with state-of-the-art, advanced instruments and equipments for complete care for all gastro intestinal and HPB (Hepatopancreatobiliary) diseases. Our multi-disciplinary approach including Medical Gastroenterology/Hepatology, Interventional Radiology and Critical Care Units enables us to work as a team, providing patients with the expert care they need for management of complex gastrointestinal problems.
The skilled team of consultants and doctors has a large experience in the management of these diseases with emphasis on:
- Oncological Surgery of the Liver, Biliary Tract, Pancreas and Gastrointestinal Tract
- Pancreaticobiliary Surgery
- Gastric and Oesophageal Surgery
- Advanced Laparoscopic Surgical Procedures
- Specialised Colorectal Surgery
- Stapled and Pouch Procedures for Inflammatory Bowel Diseases
- Laparoscopic Surgery for Morbid Obesity
Management of cancers is handled on the basis of protocols already in place. This close association between the departments allows patients to get integrated care for their diseases. Unlike most other centres, all phases of the treatment can be completed under one roof. Treatment for colorectal cancers, cancers of the stomach and pancreas, cholangiocarcinoma, etc. are taken up after detailed discussions between the surgeon and the oncologist. This interaction helps in the optimisation of the treatment for each patient. Manipal Hospital is in a unique position to provide comprehensive evaluation and treatment for liver cancers, since all modalities of treatment options are available and the option best suited for a patient and the state of the disease is offered.
Liver Surgery: Hepatic/liver resections are done commonly for liver tumours. It requires good pre-operative planning, meticulous surgery and intensive post-operative care for good results following hepatectomy.
Pancreas: We routinely perform major pancreatic resections and surgery for chronic pancreatitis with results being comparable with the best centres in the world. Surgical treatment is offered to patients with pancreatic cancers as well as chronic pancreatitis.
The following procedures are routinely performed:
- Whipples Pancreaticoduodenectomy for Carcinoma Pancreas and Periampullary Carcinoma
- Lateral Pancreatojejunostomy, Head-Coring with LPJ for Chronic Pancreatitis
- Distal Pancreatectomy (often done laparoscopically)
- Median Pancreatectomy
- Pancreatic Necrosectomy and Surgery for Pseudocyst (often done laparoscopically)
Disorders of the Biliary System
The treatment of gallstone disease is done in coordination with the Department of Medical Gastroenterology so as to allow planning of combined and sequential treatment procedures that would help in reducing the hospital stay. Surgical management of complicated benign biliary disorders is done by biliary reconstructive procedures. The department has accomplished itself in the management of bile duct injuries after a gall bladder surgery and in the treatment of choledochal cyst with results at par with the best centres in the world.
Bile Duct and Gall Bladder Cancer
Palliative and curative resections for biliary cancer and palliative drainage procedures are performed. Combined liver and bile duct resection for advanced bile duct cancers are being performed regularly with excellent results. Patients who have inoperable diseases are offered various palliative measures like Stenting or Bypass procedures.
Advanced Laparoscopic Surgery
The team at Manipal Hospital is skilled at performing all major gastrointestinal procedures in a minimally invasive (laparoscopic) manner. Advanced laparoscopic surgery in the form of liver and pancreas resections, colorectal cancers are routinely performed with excellent outcome and benefit of early recovery and discharge.
Obesity (morbid) is a global problem with associated metabolic and other system dysfunction. The Obesity and Weight Management Clinic is a one-stop place for a comprehensive evaluation for these patients. Patients are evaluated, counseled and offered the best treatment options for their problems. All forms of obesity surgery are performed laparoscopically with excellent short and long term results.
The procedures routinely performed by the department include:
- Endoscopic treatment of Gastrointestinal (GI) bleeds through injection, bands, clips and Argon Plasma Coagulation (APC)
- Endoscopic management of Achalasia Cardia
- Endoscopic dilatation of strictures and placement of metal stents in oesophagus, stomach, duodenum, colon and bile duct
- Percutaneous endoscopic gastrostomy
- Endoscopic removal of foreign bodies
- Colonoscopic polypectomy, stenting and decompression
- Endoscopic treatment of pancreatic disorders and pseudo-cyst
- Endoscopic treatment of obstructive jaundice
- E.R.C.P endoscopic removal of stones from bile duct, pancreatic duct and stenting
- Endoscopic ultrasound (EUS) diagnostic and therapeutic
- EUS guided biopsy, drainage of cyst and celiac ganglion block