Gastrointestinal and Genitourinary Procedures Clinic Sarasota

The gastrointestinal tract (GI tract) houses many important organs that play an essential role in the digestion of food. These organs include the mouth, esophagus, liver, stomach, gallbladder, pancreas, small intestine, and large intestine. The rectum and anus, located within the large intestine, are included in the GI tract.

The genitourinary tract (GU tract) is comprised of the urinary and reproductive organs. These organs include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate gland, and penis).

At SIR, a number of procedures are performed to improve the function of the organs in the GI and GU tracts. These organs may be affected by such conditions as:

  • Irritable Bowel Syndrome (IBS)
  • Gastroesophageal Reflux Disease (GERD)
  • Ulcers
  • Diverticulitis
  • Crohn’s Disease
  • Celiac Disease
  • Ulcerative Colitis
  • Acute Cholecystitis
  • Choledocholithiasis
  • Gallstones
  • Liver Cirrhosis
  • Chronic Pancreatitis
  • Cancer
  • Hepatitis

Gastrointestinal (GI) Procedures

Biliary Drain Tube Placement

The liver produces a liquid called bile that aids in digestion. When the bile duct is narrowed or blocked, generally because of scar tissue or a tumor, bile cannot flow into the first part of the small intestine (duodenum), and bile then collects in the liver. The build-up of bile in the liver can cause infection, nausea, vomiting, fever, itching, and jaundice. A biliary catheter (thin, flexible tube) can be placed to drain bile from the liver. The catheter goes through the skin and into the bile ducts, avoiding the area of the obstruction. One end of the catheter rests in the small intestine, while the other end exits the body and attaches to an external drainage bag. The catheter allows the bile to flow out to the drainage bag or into the small intestine.

Biliary Stent Placement

Biliary stent placement is the insertion of a plastic or metal tube into the bile duct to relieve narrowing of the duct. It is used to treat bile duct obstruction that may be related to cancerous (e.g., pancreatic, liver, large intestine, bile duct cancers) or non-cancerous (e.g., pancreatitis, gallstones, bile duct inflammation, injury to the bile duct, radiation therapy) causes.

Feeding Tube Placement

Feeding tube placement, also known as percutaneous endoscopic gastrostomy (PEG), is performed when a person has persistent difficulty swallowing and cannot get enough food or liquids by mouth. The feeding tube is placed through the abdominal skin and directly into the stomach. It enables feeding directly into the gastrointestinal tract, thus bypassing the mouth and esophagus.

Liver FibroScan®

Gastrointestinal & Genitourinary Procedures

The liver is one of the most vital organs of the body and is responsible for a number of important functions:

  • Cleanses and eliminated toxins
  • Eliminates old red and white blood cells and certain bacteria
  • Metabolizes carbohydrates, lipids, and proteins
  • Prevents hemorrhaging
  • Produces and secretes bile, which aids in digestion
  • Stores important vitamins and energy for use by the body when needed

Liver damage results from diseases that cause gradual fibrosis (thickening and scarring) of the liver, including:

  • Cirrhosis
  • Viral hepatitis (B and C)
  • Alcoholic fatty liver disease
  • Non-alcoholic fatty liver disease
  • Auto-immune diseases

Click here to go to our "In the News" section for a detailed discussion of hepatits C, its impact on the liver, and how SIR can assist in evaluating your liver function and possible damage from hepatitis C.

Liver Cirrhosis

FibroScan® is the tradename for an ultrasound examination to assess liver fibrosis (hardness and stiffness) and steatosis (level of fat present in the liver). This noninvasive exam uses technology called vibration-controlled transient elastrophy (VCTE) to measure liver stiffness and controlled attenuation parameter (CAP) to assess and quantify steatosis.

With VCTE, an ultrasound probe emits a mechanical pulse at the surface of the skin to measure the condition of the liver through sound waves. The computer displays a two-dimensional picture of the liver and analyzes the data from ten separate readings taken of the liver. An immediate measurement of the hardness of the liver, using a range from 1.5 to 75 kPa correlated to fibrosis, is given to the physician. The harder the liver, the more serious the fibrosis is likely to be. Cirrhosis becomes a concern at 12 kPa.

CAP is currently the only noninvasive means to quantify steatosis. Prior to the development of CAP, conventional ultrasound was the only way to detect the presence of steatosis, and quantification was not even possible. VCTE and CAP are performed simultaneously and do not extend the duration of the test.

FibroScan® is easy, painless, and quick, taking less than ten minutes. It assists in diagnosing and monitoring the progression of liver disease. When close follow-up is needed, the exam may be safely repeated every 6-12 months. This follow-up helps monitor the progression of liver disease and, if treatment or lifestyle changes has taken place, helps to determine how successful those measures have been.

Percutaneous Transphepatic Cholangiogram (PTC)

PTC is a procedure used to visualize the biliary tract for possible obstruction and to diagnose diseases of the bile duct. It is also used as preliminary step in a number of biliary interventions or biliary stent placement.


Gastrointestinal & Genitourinary Procedures

Fluoroscopic image of transjugular intrahepatic portosystemic shunt (TIPS) in progress

TIPS is the acronym for transjugular intrahepatic portosystemic shunt and refers to an image-guided procedure that creates a new connection between two blood vessels in the liver—the portal vein and the hepatic vein. This connection becomes necessary when scar tissue within the liver, usually from cirrhosis, has partially blocked the flow of blood passing through the liver from the esophagus, stomach, and intestines. The blockage causes increased pressure and backup in the portal vein called portal hypertension. TIPS creates a path for blood traveling through the liver and back to the heart, thereby reducing the pressure and decreasing the likelihood of enlarged veins (varices) forming where they may burst and become life-threatening or reducing the buildup of fluid within the abdomen (ascites).

After the TIPS has been created, routine surveillance is mandatory to make sure it is functioning properly. Serial ultrasounds and periodic venograms are performed to make certain the shunt remains open. Occasionally, angioplasty or stent revision is required to keep it open.

Genitourinary (GU) Procedures

Nephrostomy Tube Placement

A nephrostomy tube is a catheter that is inserted through the skin into the kidney to drain urine into an external drainage bag. It is required when an obstruction of the ureters or other medical condition occurs that prevents urine from exiting the body in the normal fashion.

The ureters are thin, narrow tubes that carry urine from the kidneys to the bladder where it is stored prior to urination. If urine cannot pass through to the bladder and stays in the kidneys, the individual may experience pain and fullness and is subject to kidney damage. Nephrostomy tube placement can relieve discomfort caused by urine retention in the kidneys and also can help prevent kidney damage.

Percutaneous Nephrostomy

Percutaneous Nephrostomy is a minimally invasive interventional procedure during which a catheter is placed through the skin and into the kidney for relief of urinary obstruction, diagnostic testing, access for therapeutic interventions, or diversion of urine.