Gastroenterology

Our fellowship trained interventional endoscopists provide expert care utilizing state-of-the-art imaging and advanced endoscopic techniques. Also known as interventional endoscopy, this minimally invasive approach allows for the precise diagnosis, management and treatment of complex gastroenterological conditions.

Advanced endoscopy can be used as a diagnostic tool to inform precise diagnosis

Information gained from this advanced endoscopy shapes the optimal treatment plan individualized to each patient.

From samples or biopsies that can be obtained during your advanced endoscopy procedure- our pathology team will examine the specimen to determine if the specimen is benign, precancerous or cancerous. Advanced endoscopy can aid other medical and surgical specialties in making precise fine-tuned decisions.

Examples of advanced endoscopy procedure done for diagnostic purposes are:

  • Endoscopic Ultrasound (EUS) with Fine Needle Aspiration and/or Biopsy. EUS is used to diagnose GI tract conditions, including cancers.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP). ERCP is used to evaluate and treat disease conditions affecting the bile and pancreatic ducts. During ERCP bile duct stones may be removed.
  • Endoscopic Mucosal Resection (EMR), Endoscopic Submucosal Dissection (ESD), Endoscopic Full Thickness Resection (EFTR). EMR, ESD and EFTR are types of advanced endoscopic procedures used to remove complex, large polyps within the lumen of the GI tract.

Endoscopic ultrasound supports both diagnostic and therapeutic procedures

EUS uses high-frequency sound waves to produce precise detailed images of the GI tract and surrounding organs during diagnostic evaluation.

EUS is also used to guide the advanced endoscopist during therapeutic procedures to visualize detailed images of the GI wall, lymph nodes, blood vessels and surrounding organs, such as the gallbladder, liver and pancreas.

EUS can also be used for therapeutic purposes including:

  • Drainage of large symptomatic pseudocysts and infected walled-off pancreatic collections
  • Drainage of abscess collections
  • Establishing biliary access in malignant conditions affecting the bile duct
  • Celiac plexus nerve block/ablation
  • As an adjunct in the removal of subepithelial GI lesions

Therapeutic procedures with advanced endoscopy offer patients a minimally invasive approach

Prior to this leading-edge technology being available, patients may have had to undergo more invasive surgeries to diagnose and treat complex GI conditions.

Common advanced endoscopy interventions we perform:

  • Barrett’s Esophagus ablation for the destruction of abnormal (precancerous) lining of the esophagus through the application of heat energy or a cryogen (freezing).
  • Bile duct stone removal for the the extraction of obstructing stones within the bile duct through its opening into the small intestine.
  • Pancreatic cyst management for clinically indicated drainage of symptomatic peripancreatic collections using a stent through the wall of the GI tract in a minimally invasive manner.
  • Removal of large polyps EMR, ESD and EFTR techniques to remove large precancerous (and sometimes, cancerous) lesions in the esophagus, stomach, small intestine and large intestine.
  • Single balloon enteroscopy uses a special endoscopic device to evaluate and treat certain disease conditions affecting the middle (jejunum) and distal (ileum) small intestines.
  • Stent placement with metallic or plastic, tubular hardware designed for restoring luminal patency in the GI tract – including the esophagus, small intestine, large intestine, bile duct and the pancreas duct.

Palliative support can be provided with advanced endoscopy

There are instances where advanced endoscopy can support patients where their disease is not curable but advanced endoscopy can provide comfort measures. Example of using advanced endoscopy for palliative purposes is pain relief for patients with advanced pancreatic cancer or stenting blockages that may be caused due to cancers of the GI tract. The technology can be used to relieve pain and improve quality of life.

Multidisciplinary advanced care close to home

Riverside’s advanced endoscopy program brings our community the latest technology and advancements in endoscopy. Our patients can receive outstanding state-of-the-art care close to home.

Our advanced endoscopists are part of comprehensive multidisciplinary team of providers that care for patients with complex GI conditions. You can expect coordinated care, as our advanced endoscopy team works seamlessly with your referring provider and care team, whether your provider is within Riverside or within the community at large..

What to expect during your consultation

Prior to any advanced endoscopy procedure being scheduled, you will have a dedicated office visit where your health history will be reviewed along with any imaging studies you may have had. Our providers will answer any questions you may have and discuss recommendations on the type of advanced endoscopy procedure and how you will need to prepare for your procedure.

Call 757-599-6333 to schedule your advanced endoscopy consultation.

Meet our Advanced Endoscopists

Our fellowship trained gastroenterologist and interventional endoscopists have specialized training in advanced endoscopic techniques.
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Olumide Ajayeoba, M.D.

Dr. Ajayeoba's medical interests include gastrointestinal bleeding, gastroesophageal reflux disease, colon polyps, bile duct disorders, Barrett’s esophagus and chronic pancreatitis.

Meet Dr. Ajayeoba

Paul T. Kröner F., M.D.

Dr. Kröner's medical interests include advanced endoscopic procedures for the treatment of conditions of the esophagus, liver, pancreas and colon.

Meet Dr. Kröner