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In March 2022, the AdventHealth Center for Interventional Endoscopy (CIE) celebrates its 10-year anniversary. The CIE’s world-renown team of interventional gastroenterologists use the latest advances in diagnostic and minimally invasive therapeutic modalities to manage a wide range of gastrointestinal diseases, from swallowing disorders, pancreaticobiliary diseases to endoscopic resection of esophageal, gastric and colonic pre-cancerous and cancerous lesions.
Founded in 2012, the AdventHealth CIE was the first interventional endoscopy center to open in Central Florida. Today, it has evolved to become one of the largest complex endoscopy centers in the country with physicians in the top of their disciplines.
Research, knowledge generation and training the next generation of advanced endoscopists is at the center of the AdventHealth CIE, and this work enables the team to provide better clinical outcomes for patients.
Reflecting on the 10-year milestone, Muhammad K. Hasan, MD, medical director of the AdventHealth CIE, answered several questions about how the CIE physicians are changing the future of endoscopy as well as new technologies that enhance patients experience before, during and after surgery.
How has interventional endoscopy evolved over the last decade? What kind of developments have you witnessed and experienced during the past 10 years?
With advances in medicine and technology, interventional endoscopy has rapidly evolved over the last decade.
Since the opening of the CIE a decade ago, we have quickly established ourselves as the referral center of excellence for a variety of advanced procedures, including endoscopic ultrasound, Endoscopic Retrograde Cholangiopancreatography, endoscopic mucosal resection and deep enteroscopy. Yet, our goal has always been to remain at the forefront of change. As such, we have continued to innovate and expand the field of minimally invasive endoscopy.
Over time, we have further added complex procedures, such as endoscopic necrosectomy for pancreatic necrosis, endoscopic submucosal dissection for pre-cancerous and cancerous lesions, treatment of Zenker’s diverticulum, endoscopic treatment of achalasia and gastroparesis (POEM and G-POEM) among other complex procedures.
What’s new at CIE?
In December 2021, we opened Central Florida's first dedicated Pancreatic Center which, provides comprehensive and coordinated care for patients with a range of pancreatic conditions including recurrent acute pancreatitis, chronic and hereditary pancreatitis, and pancreatic cysts. The Pancreas Center at CIE also offers hereditary pancreatic screening and can help facilitate care for patients with pancreatic cancers.
Additionally, we recently expanded the CIE’s Third Space Endoscopy program, also known as submucosal endoscopy. This is a highly specialized program is the only center in Central Florida and is focused on minimally invasive techniques for the management of a variety of gastrointestinal disorders, ranging from endoscopic resection techniques for the removal of early cancers to the treatment of complex motility disorders. In aggregate, these highly specialized procedures offered at the CIE represent a minimally invasive alternative to conventional surgery.
What are the most innovative aspects of the AdventHealth CIE?
We can now treat a lot of complex GI diseases endoscopically that previously would have required major surgery. These advanced endoscopic interventions are an alternative to more invasive surgeries that, in turn, translates into speedier recovery for the patient. For the physician, it means less time for their patients in the hospital and avoidance of major morbidity of surgery.
How are interventional endoscopists transforming the industry and improving patient care?
The demand of minimally endoscopic interventions that can decrease the morbidity associated with surgery and shorten hospital stay is increasing. Working in conjunction with industry, interventional endoscopists continue to lead the revolution in minimally invasive strategies for the management of a variety of gastrointestinal disorders. The ultimate goal is to continue to develop best practice techniques to achieve optimal patient care while minimizing unnecessary health care utilization.
Are there procedures offered at the CIE that are not offered anywhere else in Central Florida?
The AdventHealth CIE is the most comprehensive interventional endoscopy center in Florida and is one of only a few programs in the nation to offer advanced pediatric complex endoscopy services, including complex ERCP for infants and neonates.
The CIE is the only center in Central Florida that offers a complete third space endoscopy program, including endoscopic submucosal dissection (ESD) for pre-cancer and cancer lesions in the gastrointestinal tract, to peroral endoscopic myotomy for diverse esophageal and gastric motility disorders.
The CIE is a leader in interventional endoscopic ultrasound, a new and exciting subspecialty within the advanced endoscopy that allows treatment of complicated pancreaticobiliary diseases previously reserved to surgery or interventional radiology.
In 2022, we will continue to expand our services to include a comprehensive endoscopic bariatric program for the treatment of obesity.
How have physicians changed the experience, from procedure to post-op?
The CIE offers the most innovative minimally invasive techniques for a management of a variety of gastrointestinal disorders. When compared to conventional surgery, many of these procedures are associated with similar or improved clinical outcomes, better safety profile and faster recovery. As such, many of these procedures are performed with same day discharge, obviating the need for prolonged hospitalization, health care utilization and time away from work for the patients.
Will the first accredited GI fellowship program in Central Florida likely have an impact on CIE? If so, how?
The physicians within the AdventHealth CIE strongly believe in advancing and encouraging lifelong education of the next generation of endoscopists. We have featured an advanced endoscopy-training program since 2013 and have trained multiple, talented gastroenterologists from the U.S. and abroad. The faculty at CIE is devoted to the GI fellowship program and will continue to be an integral part in the education and training of future gastroenterologists and interventional endoscopists alike.
Looking ahead, what types of advancements do you foresee in 2022 and the decade beyond?
We already provide the most comprehensive and innovative endoscopic program in Florida and are committed to lead advances in the field of interventional endoscopy.
Later this year, we anticipate opening the CIE endoscopic bariatric program for the management of obesity. This program will offer patients access to a multitude of endoscopic weight-loss procedures that range from gastric balloons to endoscopic sleeve gastroplasty (ESG), commonly called “the accordion procedure.” The ESG uses an endoscope with an attached suturing device to place sutures in the stomach. It’s minimally invasive and serves as an alternative to traditional gastric sleeve surgery.
Over the next decade, we foresee the introduction of novel hybrid endoscopic and surgical techniques for the management of a variety of disorders. We have also witnessed the ever-changing landscape of artificial intelligence in medicine and expect to incorporate these latest technologies in the care of our patients.
What would you like your fellow physicians to know about the AdventHealth CIE and the future or interventional endoscopy?
The AdventHealth CIE offers the entire spectrum of interventional procedures for your patients’ complex needs. The physicians at CIE are highly skilled, national experts in their subspecialties and can help provide a second opinion in complex and challenging cases. Our goal is to provide best practice techniques in the care of your patients.
Are they any discussions that have been shared on Grand Rounds that you’d like to highlight for other physicians here?
Continued education of physicians and physicians and gastroenterologists at the community and global level is of paramount importance. In this era of uncertainty where travel is restricted, we developed the “CIE Monthly Grand Rounds” to provide education globally and show live cases from the AdventHealth CIE. These live webinars are an opportunity for physicians to hear from leading interventional endoscopists as they highlight the cutting-edge techniques and demonstrate its application live, in a practical manner to enable participants to incorporate this experience into their daily clinical practice. To join our monthly Grand Rounds live webinars, email [email protected] to be added to the distribution list.