Dr. Raja Sappati, a physician at Phoebe Gastroenterology Associates, is using an endoscopic ultrasound technology considered relatively new to the field. (Submitted photo)
ALBANY — Dr. Raja Sappati, a new physician at Phoebe Gastroenterology Associates, has brought to Southwest Georgia an endoscopic ultrasound method said to improve the diagnosis of cancers, gallbladder disorders and other issues in the chest and abdomen.
Prior to Sappati’s arrival, officials say, patients in the region had to travel to specialists in Macon and Tallahassee, Fla. for the procedure. Given by referral only, the combination of upper endoscopy and ultrasound examination is used to gather information about various parts of the digestive tract, and to examine the esophageal and stomach linings as well as the walls of the upper and lower gastrointestinal tract.
“It looks like an upper endoscopy, but you can see more detail, and at the same time it gives me the option to biopsy,” Sappati said. “I can see neighboring structures, take a look at the chest, pancreas, kidneys and the left lobe of the liver.
“It plays an important role in pancreatic cancer.”
Patients undergoing the 60-90 minute outpatient procedure at the Phoebe Putney Memorial Hospital are given a sedative to produce relaxation and sleep. During the ultrasound, an upper endoscope with a built-in ultrasound device installed on the tip is inserted into the upper or lower digestive tract to produce images of organs, nearby lymph nodes and blood vessels. It uses sound waves to make a picture of internal organs, making it possible to perform biopsies in areas otherwise not accessible without surgery.
Sappati says results can help cancer doctors and surgeons determine the extent certain cancers of the digestive and respiratory systems have spread that cannot be detected to the same degree as with computerized tomography (CT) scans, magnetic resonance imaging scans or by traditional ultrasound outside the body. It also reveals the cancer’s depth and whether it has spread to adjacent areas.
It allows for tumor staging and diagnosis for gastric tumors, pancreatic cancer, neuro-endocrine tumors, esophageal cancer, ampullary adenoma and rectal cancer. It also helps to diagnose submucosal lesions and thickened gastric folds, and is also used for the endoscopic mucosal resections of large colon polyps and duodenal adenomas.
It can also be helpful, the physician said, by offering reassurance closer to home by those already frightened by what they have heard only to learn later that a more detailed look has revealed that an uncovered abnormality is not as bad as initially thought.
“On a CT scan, you can only see it,” Sappati said. “With endoscopic ultrasound, you have the option of getting the needle and getting a biopsy. It provides answers to what cancer treatment to take … it can help with local staging. It helps the oncology people to guide therapy.
” … Oncology can know the stage, and can tailor the treatment to that. It helps to know what you have and what stage it is.”
Used in conjunction with endoscopic retrograde cholangio pancreatography, the technology can also be used to locate gallstones that have migrated into the common bile duct. The technology came to the area in August, and since then, Sappati said, he has been establishing a lab and brushing up the staff at his office on how the procedure works.
“There will be a growing patient base as folks find out about it,” the physician said.