Pindara Leading the Way with New Endoscopy Procedure The small intestine is currently the most inaccessible part of the gastrointestinal tract, making it difficult to treat conditions in that area when they arise. However, this will not be the case for much longer when doctors at Pindara Private Hospital begin routinely offering the first double balloon entersocopy procedures on the Gold Coast, where previously patients had to travel to Brisbane. Double balloon enteroscopy, or push-pull enteroscopy, is an endoscopic technique that allows the visualisation of the small intestine. This technology debuted in 2001 and was the first endoscopic procedure that allowed for the entire gastrointestinal tract to be visualised in real time. Pindara Private Hospital conducted trials of this technique during 2016 and plans to begin making it available in early 2017. Interventional Gastroenterologist Dr Michael Murray said the small intestine is the ‘final frontier’ of the gastrointestinal tract. “The reason it is hard to get to is that is wriggly and mobile, and not fixed. With the two balloons, placed about a foot apart, you can anchor the scope in position as you go through.” The piece of equipment used is comprised of a long, thin scope with an over tube used to guide the scope. With the over tube, along with a technique of inflating and deflating the two balloons, the small intestine is concertinaed onto the scope. As the scope moves forward through the small intestine, the camera allows the complete examination of the small bowel. When necessary, interventional procedures can also take place using the scope. “It is used to get biopsies from the small intestine and do procedures like treating bleeding lesions, taking off polyps, putting in stents and using balloon devices to stretch narrowing,” said Dr Murray. This technology is also in high demand in an ever increasing group of patients who have an altered gastrointestinal anatomy due to weight loss surgery. Traditionally, to investigate and perform procedures in the small intestine which could not be reached from a standard gastroscopy or colonoscopy, invasive procedures such as open surgery would need to be performed. As it is a non-invasive procedure, doubleballoon enteroscopy is associated with minimal discomfort and a very low complication rate allowing patients to have a shorter recovery time. NEWS “Start the Conversation” Community Health Campaign Over five million people suffer from obesity in Australia. This debilitating condition is no longer considered a cosmetic issue caused by overeating and lack of control, rather, The World Health Organisation now recognises that obesity is a chronic progressive disease that results from multiple environmental and genetic factors. Obesity has been well established as a cause of diabetes, heart disease and infertility and has now also been linked to 13 different types of cancer including colorectal and breast cancer. Husband and wife team, Dr Jacobus Jordaan and Dr Nova Jordaan, have launched a new community engagement campaign to educate the public on the dangers of obesity and help break down the barriers to seeking treatment. The “Start the Conversation” program launched with an educational social media campaign, radio campaign and free educational sessions, and aims to educate the community on the impact of obesity while encouraging sufferers to have the confidence to talk to their general practitioner about treatment. “The reality is that research has shown time and again that people suffering from obesity can’t just eat well and exercise to lose a large amount of weight. They need clinical intervention and medical treatment but often feel too judged to ask for it,” said Dr Jacobus Jordaan. The campaign was originally sparked from research presented by leading obesity researcher Professor John Dixon at the Royal Australasian College of Surgeons (RACS) symposium this year that said 98% of people who would benefit from bariatric surgery were not accessing it. “GPs tell me how hard it can be for them to start the conversation with their patients about how weight affects their health. Then patients come into my surgery and tell me how hard it was for them to start the conversation with the GP,” said Dr Jacobus Jordaan. It is the perception people have around weight loss surgery as being judged for taking “the easy way out” as well as accessibility which are the problem said Dr Nova Jordaan. “This is our opportunity to give back to community. We have made our services as accessible as possible including introducing a streamlined program for eligible patients that focuses on reducing the cost as much as possible. Now, we need to de-stigmatise this and get people to feel comfortable bringing it up with their GP,” she said. “It is a disease and you wouldn’t leave any other disease untreated. There are escalating tears of treatment starting with diet and exercise, add in medication then add in surgery. The GPs are in the best place to assess that plan for a patient,” she said. While Dr Nova and Dr Jacobus Jordaan realise they have an uphill battle, they are hoping that by providing awareness and tools for patients and GPs, the perceptions in the community start to shift. “We have a treatment that works and I would be really thrilled to go back to RACs in 5 years and see that when John Dixon puts up the pie chart of patients in Australia who are eligible and have accessed this option the numbers have doubled or tripled,” said Dr Nova Jordaan. 2016 10 Pindara Magazine 2016
Pindara Private Hospital Magazine - Issue Nine
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