Interventional endoscopy
Gastroenterological endoscopy at Medical Clinic I covers the entire spectrum of diagnostic and therapeutic endoscopy of the gastrointestinal tract, including the draining bile ducts and the pancreas.
Experienced gastroenterologists under the direction of Prof Dr Benjamin Walter and highly qualified medical-technical staff care for patients from the entire hospital. This includes both the outpatient and inpatient areas. The latest generation of equipment enables the best possible diagnostics and the use of new procedures.
As a university unit, we feel obliged to treat all patients according to the latest state of knowledge, and we ourselves work scientifically on new procedures in order to maintain medical progress.
- Endoscopy
- Emergency endoscopy
- Endoscopy outpatient clinic
- Short berth station
- Occupancy management
- Hotline for doctors
Endoscopy
Phone 0731 500 - 44632 / -35
Telephone availability:
Monday to Thursday: 13:00 to 15:00
or by e-mail to: termin.endoskopie@uniklinik-ulm.de
Emergency endoscopy
Phone 0731 5000
Opening hours:
The emergency endoscopy department is available to you at any time outside regular office hours.
Endoscopy outpatient clinic
Phone 0731 500 - 44032 / -44805
If your symptoms are unclear or in preparation for complex procedures, please visit our endoscopy outpatient clinic. It can then be determined on site which examination procedure is most suitable or whether an inpatient admission appears necessary. The appropriate information is also provided in the outpatient clinic. Any laboratory tests required in advance will be discussed.
Consultation hours:
Monday to Thursday from 13:00 to 16:00, by prior arrangement by telephone!
Short berthing station
Patients are admitted to our short-stay ward for complex interventional procedures. As a rule, an appointment in the endoscopy outpatient clinic is required in advance. Patients requiring complex interventional procedures can be registered via our patient management team.
Occupancy management (for inpatient/short-stay admissions)
Phone 0731 500-44583
Fax 0731 500-44589
Opening hours:
Monday to Friday from 08:00 to 16:00
Contact person
Mr Markus Negele
Hotline for doctors
Phone 0731 500 - 44777 (senior gastroenterologist on duty)
Availability:
Monday to Friday from 08:00 to 16:00
You can reach the senior doctor on duty (for medical colleagues) on the hotline for doctors.
Team
Our clinic offers all relevant examinations around the clock in a 24-hour emergency service. The responsible medical and nursing service can be contacted at any time via the University Hospital's control centre.
The perfect hygienic condition of our endoscopes is of particular concern to us. All our employees are specially trained for this. The endoscopes are reprocessed in accordance with the guidelines of the Robert Koch Institute and fully documented for each individual endoscope. The Institute for Medical Microbiology and Hygiene, Clinical Hygiene Section, regularly checks that the endoscopes are in perfect hygienic condition.
Strict guidelines apply to the use of sedatives ("sleep injection") in endoscopy (S3 guideline "Sedation in gastrointestinal endoscopy"). All patients' heart rate, blood pressure and blood oxygen levels are continuously monitored during the examination. A separate recovery room is available after the examination, where you will be looked after and monitored by a trained nurse.
Focal points
The Endoscopy Department at the Centre for Internal Medicine at Ulm University Hospital offers a wide range of diagnostic and therapeutic gastrointestinal endoscopy procedures. All examinations are carried out by experienced and specially trained examiners.
Diagnostic endoscopy
- Oesophago-gastro-duodenoscopy
- High-resolution video endoscopy
- Zoom endoscopy / NBI visualisation
- Chromoendoscopy
- Tissue sampling by means of forceps biopsy
- Endosonography and endosonography-guided puncture
- Radiological imaging of stenoses, strictures, fistulas or leaks
Therapeutic endoscopy
Our endoscopy department specialises in performing highly complex endoscopic-interventional procedures. Prof Walter will be happy to answer any questions you may have.
- Bougienage / dilatation of stenoses
- Balloon dilatation of the lower oesophageal sphincter (achalasia)
- Stent implantation for stenoses
- Argon plasma coagulation (APC) and laser therapy
- Splitting of Zenker's diverticula
- Endosonographically guided punctures
- Drainage and necrosectomy for severe forms of pancreatitis
- haemostasis
- Rubber band ligation and sclerotherapy for oesophageal and fundic varices
- Mucosal resection or submucosal dissection
- Polypectomy
- Foreign body removal
- PEG placement (percutaneous endoscopic gastrostomy) using the pull-through and direct puncture technique
- Placement of nasogastric feeding tubes
- Endoscopic full-wall resections
- Ablation procedures for Barrett's oesophagus (BarrX therapy)
- 3D planimetry of narrow sections of the oesophagus
Diagnostic endoscopy
- Capsule endoscopy with possible prior patency capsule
- Single balloon enteroscopy
- Spiral endoscopy
- Tissue sampling using forceps biopsy
Therapeutic endoscopy
- Balloon dilatation of tumour or scarred stenoses
- Argon plasma coagulation (APC)
- Haemostasis
- Polypectomy
Diagnostic endoscopy
- Ileo-colonoscopy and recto-sigmoidoscopy (flexible)
- Proctoscopy (rigid)
- Zoom endoscopy / NBI visualisation
- Chromoendoscopy
- Tissue removal by means of forceps biopsy
- Endosonography and endosonography-guided puncture
- Radiological imaging of stenoses, strictures, fistulas or leaks
Therapeutic endoscopy
- Bougienage / dilatation of stenoses
- Stent implantation for stenoses
- Haemostasis
- Argon plasma coagulation (APC) and laser therapy
- Endosonographically guided puncture and drainage
- Polypectomy, mucosal resection or submucosal dissection
- Removal of foreign bodies
- Haemorrhoid therapy by sclerotherapy or ligation treatment
- Endoscopic full wall resections
Diagnostic endoscopy
- Endoscopic retrograde cholangiography and pancreaticography ( ERCP )
- Cholangioscopy and mini-probe sonography
- Tissue sampling using forceps biopsy or brush cytology
- Extraction of bile for bacterial resistance testing
- Radiofrequency ablation of tumours
Therapeutic endoscopy
- Papillotomy (papillary muscle splitting) via the bile or pancreatic duct
- Stone extraction, mechanical stone fragmentation (lithotripsy) from the bile duct and pancreatic duct
- Bile duct and pancreatic duct bougienage or balloon dilatation
- Bile duct and pancreatic duct drainage (plastic, metal stents)
- Insertion of naso-biliary probes
- PTCD systems
- Rendezvous procedure to convert a PTCD into an internal bile duct drainage system
Diagnostics
- Endosonographic diagnosis of the oesophagus, stomach, small intestine, pancreas, bile ducts, liver, abdominal vessels, adrenal glands, colon and rectum
- Staging (spread diagnostics) of tumours of the upper and lower gastrointestinal tract and mediastinum
- Diagnostic punctures of tumours in the thoracic cavity, stomach, small intestine, pancreas, oesophagus and abdominal cavity
Interventions
- Endosonographically guided bile duct drainage and stent placement via the small intestine and stomach using the direct puncture technique and rendezvous procedure
- Transgastric and transduodenal treatment of severe forms of pancreatitis: Placement of self-expanding metal stents, transgastric necrosectomy, transgastric drainage of the pancreatic duct
- Endoscopic creation of gastro-enterostomies (creation of a connection between the stomach and small intestine in the case of otherwise irreparable obstructions in the upper GI tract)
Highly specialised procedures
- Diagnostic examination of the abdominal cavity and removal of tissue samples ("mini-laparoscopy")
- HVPG (minimally invasive measurement of portal vein pressure)
- TIPS (creation of a vascular short circuit in cases of portal vein hypertension in cooperation with the Department of Interventional Radiology)
- Emergency TIPS procedure for acute haemorrhages
When is a colonoscopy necessary?
A colonoscopy is performed if the patient complains of pain in the lower abdomen, has chronic diarrhoea, blood has appeared in the stool or for cancer screening. The examination can then reveal whether there is inflammation or polyps (= benign mucosal growths), for example.
How does the examination work?
The day before the examination, the patient must drink a laxative solution to completely empty and cleanse the bowel. Apart from emergencies, the patient should not have eaten for at least six hours beforehand. Whether it is possible and sensible to take medication on the morning of the examination must be discussed on a case-by-case basis. As a rule, sedation ("sleeping injection") is given for the examination. If this is the case, continuous circulatory monitoring is carried out.
The examination usually takes about 20 minutes. The patient can then go about their usual activities. If sedation (sleeping injection) has also been given, the patient will be monitored in our recovery room for 2 hours afterwards and may not actively participate in road traffic, make important decisions or work on dangerous machinery for 24 hours.
When is an ERCP necessary?
This examination is carried out if there is a suspicion of narrowing or stones in the bile duct or in the case of specific diseases of the pancreas.
How does the examination work?
Apart from emergencies, the patient should not have eaten for at least six hours beforehand. Whether it is possible and sensible to take medication on the morning of the examination must be discussed on a case-by-case basis. As a rule, sedation ("sleeping injection") is given for the examination and the patient is continuously monitored. The endoscope is inserted through the mouth, oesophagus and stomach into the duodenum. It is aligned with the papilla , the common duct of the common bile duct and pancreas. A thin probe is then inserted into the bile duct, which is filled with a contrast agent and visualised using X-rays. This procedure is a combination of endoscopic and radiological techniques. If, for example, a gallstone is found in the bile duct, it can be removed during the same examination. Another example of a "therapeutic ERCP" is the insertion of plastic or metal mesh endoprostheses for narrowing of the bile duct.
The examination usually takes about 45 minutes. The patient can then go about their usual activities. If the patient has also received sedation (sleeping injection), they will be monitored in our recovery room for 2 to 4 hours afterwards and may not actively participate in road traffic, make important decisions or work on dangerous machines for 24 hours.
When is a gastroscopy necessary?
If, for example, the patient complains of severe abdominal pain, the cause of which is not yet known, the doctor will perform a gastroscopy. The cause of the pain may be gastritis or a stomach ulcer, for example. With the help of the endoscope, the doctor can take a close look at the stomach lining and recognise the smallest changes such as inflammation and small, usually harmless growths.
How does the examination work?
The endoscope is inserted via the mouth through the oesophagus and stomach into the upper duodenum. Apart from emergencies, the patient should not have eaten for at least six hours beforehand. Whether it is possible and sensible to take medication on the morning of the examination must be discussed on a case-by-case basis. Local anaesthesia makes it easier to insert the device. Sedation ("sleeping injection") can also be administered. In this case, the circulation is monitored.
The examination usually only takes a few minutes. The patient can then go about their usual activities. Only if they have also been given sedation (sleeping injection) will they be monitored in our recovery room for 2 hours afterwards and must not actively participate in road traffic, make any important decisions or work on dangerous machinery for 24 hours.
Please bring the following with you to the examinations
- Health insurance card
- referral slip
- Patient information with informed consent
If you have an X-ray passport, an allergy passport or a tumour aftercare calendar, please bring these with you so that we can fill them in straight away.
Please note
that you must be monitored for approx. 2 hours during an outpatient examination following the administration of sedation (sleeping injection). For legal reasons, it is not permitted to drive a vehicle, operate dangerous machinery or sign important contracts during the following 24 hours.
If possible, you should be picked up by an accompanying person after the examination. It would be a good idea to have someone to look after you in the following hours as well.
Endoscopy outpatient clinic
If your symptoms are unclear or in preparation for complex examinations, it may be advisable for you to be examined in our outpatient clinic first. We can then decide on the spot which examination procedure is best suited to you. In the outpatient clinic, you will be informed about the examination and any necessary laboratory tests will be carried out.
Endosonography combines the less invasive technique of endoscopy with high-resolution sonography. An ultrasound probe is installed at the tip of the endoscope. This allows the doctor to visualise and assess the digestive tract directly on the one hand and, on the other, to display the stomach and intestinal walls and the structures behind them on the screen with the help of ultrasound.
For the patient, the examination is carried out in the same way as a normal gastroscopy or colonoscopy. The examination usually takes about 30 minutes. The patient can then go about their usual activities. Only if they have also received sedation (sleeping injection) will they be monitored in our recovery room for 2 hours afterwards and must not actively participate in road traffic, make any important decisions or work on dangerous machines for 24 hours.
Further information on the individual examination techniques, preparations and procedures can be found in the information forms.
quality
Our endoscopy department has been ISO 9001: 2000 certified since 2003. The quality of our work is regularly monitored as part of this certification.