Advanced Endoscopy in Delhi

Advanced endoscopy covers the specialised diagnostic and therapeutic procedures used to manage complex gastrointestinal, pancreatic and biliary conditions beyond routine endoscopy — third-space procedures such as POEM, ESD and EFTR, endoscopic ultrasound with tissue sampling and drainage, and therapeutic ERCP.

Third-space endoscopy uses the space within the wall of the gastrointestinal tract, between the lining and the muscle, to perform minimally invasive treatment. Through a tunnel made inside the wall the endoscopist can divide muscle, as in POEM for achalasia, or remove a lesion arising from the deeper layers. The entry point is closed at the end, so there is no external wound.

Advanced procedures performed by Dr Surakshith T K include POEM, ESD, EMR, EFTR, endoscopic ultrasound with FNA and FNB, therapeutic ERCP, EUS-guided drainage of pancreatic fluid collections, bile duct and gallbladder, pancreatic duct intervention, endoscopic haemostasis, stricture dilatation and stenting.

A specialist assessment is appropriate when a condition needs complex endoscopic treatment rather than a routine test: confirmed achalasia, an early cancer or large polyp found at endoscopy, a pancreatic or bile duct problem needing EUS or ERCP, a subepithelial lesion, or a procedure already attempted elsewhere without success. It is also reasonable to ask for a second opinion before agreeing to surgery.

For selected conditions, yes. POEM is an established minimally invasive treatment for achalasia and is an important alternative to surgical myotomy in appropriately selected patients; ESD and EFTR can remove early cancers and subepithelial tumours endoscopically; and EUS-guided drainage treats pancreatic fluid collections that would otherwise need an operation. Whether this applies to a particular patient depends on the disease, its depth and their anatomy, and surgery remains the right recommendation where it is the safer option.

Dr Surakshith T K is a Senior Consultant Gastroenterologist, Hepatologist and Therapeutic Endoscopist (MBBS, MD, DNB Gastroenterology from Sir Ganga Ram Hospital) with more than 15 years of clinical experience, 250+ third-space procedures including 200+ POEM, and more than 10,000 ERCP and 5,000 EUS procedures. He trained in ESD and image-enhanced endoscopy at Jichi Medical University and the Osaka International Cancer Institute in Japan, and practises at Fortis Escorts Hospital, Okhla, Holy Family Hospital, New Friends Colony, and Kalka Gastro Liver & Obesity Clinic, Kalkaji.