Information alert

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Introduction

This booklet has been designed to provide information regarding a new clinical procedure which you have been offered. It aims to explain why treatment is needed and why this procedure may help. It also explains what you have to do to prepare, provides information about the procedure and answers some of your questions. Please read this information carefully, taking as long as you need to understand it. Please ask if there is anything you do not understand or if you have any questions. 

This hospital is using a new tissue removal device called the Full Thickness Resection Device®. Because you have a benign (non-cancerous) growth in your upper digestive tract (oesophagus, stomach or small bowel) which requires regular monitoring, you have been offered an endoscopy using the Full Thickness Resection Device®. Using this device, we will aim to remove this growth from your upper digestive tract. 

Current methods of tissue sampling during endoscopy are often unreliable and for that reason patients often require repeat procedures every two to three years for monitoring. The Full Thickness Resection Device® is a tool that can help doctors completely remove these growths and obtain more tissue than usual techniques allow. This should therefore help us to decide if patients require regular monitoring or if any further treatment is necessary.

For most people an endoscopy is a simple and safe procedure. All treatments and procedures do, however have risks, and we will talk to you about the risks of endoscopy and those specific to the Full Thickness Resection Device® at an outpatient appointment before the procedure. Recent studies suggest that the Full Thickness Resection Device® is safe. 

Problems that may happen straight away

As with all endoscopic sampling devices, the most common risks are damage to or perforation (a hole) in the oesophagus, stomach or small bowel wall, bleeding requiring intervention, infection and damage to teeth.  

If bleeding occurs which requires intervention it can usually be treated during the procedure.   

Small perforations can sometimes also be treated during the procedure but larger perforations may require surgery.  

Sedation may slow your breathing or cause your oxygen levels to drop.

Problems that may happen later

You may experience a sore throat and discomfort for one to two days after the procedure.  

Delayed bleeding occurring after you have been discharged may require you to be admitted to hospital for treatment. It is also possible that you may be left with an undiagnosed perforation. These complications are very rare.   

If you have any problems after the procedure such as bleeding, or abdominal pain please contact us as soon as possible on the telephone numbers at the end of this leaflet. 

You do not have to have this procedure. Alternatives to this procedure include a CT or MRI scan, although neither are as accurate nor allow us to take samples. Having regular endoscopies with biopsies is another alternative although this approach can often be unreliable. Before you decide to continue, talk to your doctor about what these tests involve and what risks are associated with them.

Please do not eat or drink for six hours before the examination. You may have sips of water up to two hours before. 

On the day of your endoscopy, please bring a list of all the medications you are currently taking. 

As you will need to be sedated for your procedure, please arrange for someone to take you home after the procedure and be with you for 24 hours afterwards.

If you are taking any blood thinning medications such as warfarin, clopidogrel, rivoroxaban, apixaban or any others, you should receive specific instructions on what to do regarding these medications during your clinic appointment. If you have not received this information, or if you have any questions, please contact Endoscopy Recovery on: 020 3447 3282

If you are diabetic and take insulin, it is important that you continue taking your insulin. We will advise you on how much to reduce the doses of your insulin when you are seen in clinic before your procedure. If you take diabetic tablets, please do not take them on the day of the endoscopy until after the procedure has been done. 

If you are pregnant, or think you may be pregnant, you should not undergo this procedure. If you are of childbearing age, you will need to take a urine test to see if you are pregnant before you can have this procedure. 

When you arrive at the Endoscopy Unit please report to the reception. From there a nurse will take you to admissions, check your personal details, check your blood pressure and you will be asked to change into a hospital gown if needed. When it is time for your procedure, you will be taken to the consenting room where you will meet the endoscopist and be asked to sign a consent form.

We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with treatment, by law we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves. Staff will explain all the risks, benefits and alternatives before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please ask to speak with a senior member of staff again. 

From there, we will take you into one of the endoscopy rooms. You will be able to take your belongings with you or they may be left with friends or relatives. Friends and relatives can wait in the waiting room. 

The endoscopist will administer the sedation via a small needle in the back of your hand and the sedation should take a few minutes to work. The sedation is not an anaesthetic and it is designed to make you relaxed, not make you go to sleep. You may also be given a small amount of oxygen during the procedure. 

Once you are comfortable, the endoscopist will start the procedure by passing a thin, flexible tube called an endoscope into your mouth. Once the doctor has identified the area to be removed, the Full Thickness Resection Device® is placed on to the endoscope and used to remove the growth.  
 

After you have had your procedure, you will be taken to the recovery area. You will be kept there for approximately one hour so the effects of the sedation can wear off. Your blood pressure and oxygen levels will be monitored during this time. 

When you are fully awake, one of the doctors will come to explain the results of your procedure. You will then be discharged with a plan made to see you again in clinic to discuss the results of the procedure. You will also receive an information sheet giving advice on aftercare and details of who to contact if you have any problems. 

If you have persistent vomiting with blood and / or severe abdominal pain this may be a sign that you need urgent medical attention so please go to your nearest Emergency Department. If you have any other concerns during work hours contact Endoscopy Recovery. If you have any concerns out of hours which cannot wait, please contact the on-call Gastroenterology Registrar.  

If you are unable to reach anyone, and you need medical attention please go to the nearest Emergency Department. 

Do read the section titled "Do I continue taking my medicines?" regarding medicines.

Do ask for an interpreter if you require one, as hospital policy states that family or friends cannot interpret on behalf of the patient.

Do ensure you have someone to take you home and stay with you for 24 hours after the procedure.

Do not drive a car or operate heavy machinery for 24 hours after sedation is given. Please have someone to take you home in a car, taxi or public transport.

Do not drink alcohol for 24 hours after sedation is given.

Do not drink milk six hours before the procedure.

Do not bring large sums of money or valuables to the hospital as we cannot accept responsibility for loss or damage. 

1. Meier B, Schmidt A, Glaser N, Meining A, Walter B, Wannhoff A, et al. Endoscopic full-thickness resection of gastric subepithelial tumors with the gFTRD-system: a prospective pilot study (RESET trial). Surgical endoscopy. 2020;34(2):853-60

Pathway Co-ordinator (Monday to Friday 09:00-17:00) 
Direct line: 020 3447 7488 
Switchboard: 08451 555 000 / 020 3456 7890 ext. 77488 
E-mail: uclh.gimedicineenquiries@nhs.net 

Endoscopy Booking Team (Monday to Friday 09:00-17:00)  
Direct line: 020 3456 7022 
Switchboard: 08451 555 000 / 020 3456 7890 ext. 67022 
E-mail: uclh.endoscopy@nhs.net

Endoscopy Recovery (Monday to Friday 09:00-17:00) 
Direct line: 020 3447 3282 Switchboard: 08451 555 000 / 020 3456 7890 ext. 73282

On-call Gastroenterology Registrar (out of hours emergencies only) 
Switchboard: 08451 555 000 / 020 3456 7890 

Address: Endoscopy Unit, University College Hospital, 2nd 
Floor Podium, 235 Euston Road, London, NW1 2BU 
 

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Page last updated: 30 April 2024

Review due: 01 April 2026