Medical Gastroenterology

The Centre of Medical Gastroenterology at Apollo hospitals Chennai consists of 10 Gastroenterologists, six Full Time & four Part Time, who carry out regular outpatient consultations and who are competent in carrying out the entire range of Diagnostic and Therapeutic endoscopic procedures. In addition to endoscopic procedures, the Centre maintains a close rapport with other allied disciplines such as surgery, radiology and pathology in the management of a wide variety of gastrointestinal and hepatobiliary disorders. This includes the treatment of gastrointestinal malignancies, pancreatic disorders, liver failure, chronic hepatitis B & C, in addition to common disorders like peptic ulcer disease and irritable bowel syndrome.

Consultants and junior doctors are available on call for handling of Gastrointestinal emergencies and whenever required endoscopic procedures are carried out at night for which a duty technician is also available on call.

Academics are not forgotten despite the busy schedule. The Centre is recognized for Diplomate of National Board training and there are at present four candidates. The teaching schedule includes ward rounds, clinical care discussion, seminars, journal club, pathology and radiology discussions. The postgraduates are also actively involved in the management of patients and learn to carry out routine endoscopic procedures under the supervision of the consultants.

Endoscopy

These include the following :

• For patients who present with gastrointestinal bleeding –
  • Banding / injection of oesophageal varices
  • Control of bleeding with adrenaline injection / argon plasma coagulation
• For patients with swallowing difficulty due to oesophageal stricture or achalasia, endoscopic dilatation can be carried out under fluoroscopic guidance. Similarly dilatation of pyloric and colonic strictures can also be carried out. In patients with oesaphageal tumours, metallic stent placement is done, after dilatation.
• In patients for whom feeding is a problem either due to neurological disorders or altered conscious levels, endoscopic placement of nasojajunaltube or PEG (Percutaneous Endoscopic Gastrostomy) tube is done.
• Endoscopic removal of gastric / colonic polyps are routinely done.
• For patients with obstructive jaundice, ERCP / papillatomy / stone extraction from CBD/biliary stenting (plastic as well as metal stents) can be performed.
• Placement of pancreatic stents in patients with severe pain due to chronic calcific pancreatitis is done.
• Oesaphageal manometry, pH studies and rectal manometry, which are available in only limited centres, are done routinely and help not only in diagnosis, but also in deciding which patients with gastro-oesophageal reflux or achalasia are likely to require surgery.
• Other routine procedures like liver biopsy, aspiration of liver abscess and diagnostic and therapeutic paracentesis are done.

On an average 50 procedures are carried out everyday. The endoscopy suite houses 3 rooms for procedures. One of them earmarked for therapeutic procedures contain fluoroscopy equipment. Internationally accepted guidelines for prevention of infection are strictly followed under the guidance of an infectious diseases specialist.

  Surgical Gastroenterology & Minimally Invasive Surgery

Major surgeries for benign and malignant conditions of oesophagus, stomach, intestines, liver and pancreas are carried out routinely. Minimally invasive surgeries like Cholecystectomy, Appendectomy, Splenectomy, Intestinal Resections, and surgery for Hiatus Hernia are frequently done. The other speciality of the centre is that complex biliary reconstruction surgery for bile duct strictures is performed on par with any other centre in the world with excellent results.

Our minimally invasive surgery division is one of the high volume centres in the country performing not only basic laparoscopic procedures but also most of the advanced laparoscopic procedures like laparoscopic oesophageal surgery, gastric resections, colorectal surgery, pancreatic surgery and small bowel surgery. We have a state of the art Aida touchscreen facility, and DVD recording facility and a newer version of the Harmonic scalpel for bloodless surgery.

Our Centre offers bariatric surgery procedures by way of gastric banding and gastric bypass procedures.

Regular ongoing teaching programmes are conducted for DNB and MRCS candidates every week.