New procedures introduced and performed in Cyprus for the first time by Dr. Pavlos Kaimakliotis
- POEM for achalasia
- G-POEM for gastroparesis
- Z-POEM for Zenker’s diverticulum
- EUS guided pancreatic pseudocyst/walled off necrosis with LAMS
- BARXX RFA for Barrett’s esophagus with dysplasia
- Placement of OTSC for fistulas, leaks and perforation closures
- ESD for early gastric and colorectal lesions
- ERCP with electrohydrolic lithotripsy (EHL) for large common bile duct stones
Additional procedures performed
- EUS FNA/FNB
- Complex ERCP
- Complex polypectomy procedures
- Ampullectomy
- Complex dilations
Radiofrequency ablation (RFA) for Barrett’s esophagus
Barrett’s esophagus is a medical condition caused by acid reflux, frequent heartburn and Gastroesophageal Reflux Disease, or GERD. Barrett’s esophagus is a precancerous condition, meaning if left untreated it could lead to the development of esophageal cancer.
BARRX is an endoscopic technique used for treatment of Barrett’s esophagus with dysplasia to prevent progression to cancer. BARRX ablation uses radiofrequency energy (heat) to destroy the superficial layer of abnormal cells. This can prevent the tissue from turning into cancer. Once the abnormal cells are gone, new, healthy cells can replace them.
Dr. Pavlos Kaimakliotis recently performed the first Barrx procedure in Cyprus in a patient with Barrett’s esophagus and high grade dysplasia. This is one of the most effective procedures to prevent progression to esophageal cancer. The Barrx procedure is now available and performed in Cyprus at the American Gastroenterology Center by Dr. Kaimakliotis.
Duodenal EMR
A 68 year old male was referred by his surgeon for endoscopic management of a giant duodenal polyp. The patient was initially referred for surgical resection which would require a Whipple operation (pancreaticoduodenectomy) due to the size and location of the tumor. Piecemeal endoscopic resection of the laterally spreading duodenal adenoma was successfully performed by Dr. Pavlos Kaimakliotis, therefore saving the patient a major operation. The patient recovered uneventfully. Histopathology revealed tubular adenoma with no HGD or cancer. The patient will follow up with endoscopy in 6 months.
EMR
POEM (Per Oral Endoscopic Myotomy) is a relatively new an advanced endoscopic procedure used to treat swallowing problems due to motility disorders such as Achalasia.
Achalasia and other motility disorders are typically caused by the lower esophageal sphincter muscle not relaxing, making it difficult for liquids and food to pass into the stomach. Other symptoms may include regurgitation of food, chest pain, weight loss and overall poor quality of life.
The benefits of endoscopic therapy are not incisions, less pain and faster recovery. The POEM technique has been adapted to treat other disorders which cause problems swallowing such as Zenker’s diverticulum. In certain patients the POEM technique can be used to treat gastroparesis as well.
Mucosal incision - After injecting a saline solution under the mucosa, 1-2cm cut is given to mucosa
Tunnel created in the submucosal space and a submucosal tunnel is created and extended into the cardia
After completion of the submucosal tunnel, the myotomy is performed
Once the myotomy is completed, the entry site is closed with clips
EUS guided pancreatic fluid collection drainage LAMS
EUS guided drainage of peripancreatic fluid collections secondary to pancreatitis has revolutionized the management of the pancreatitis related complications.
