Advanced Therapeutic Endoscopy
Advanced Therapeutic Endoscopy in Noida – Treating Complex GI Conditions Without Surgery
Diagnostic endoscopy tells you what the problem is.
Advanced Therapeutic Endoscopy fixes it — using the same endoscope, in the same procedure, without a single surgical incision.
From stopping life-threatening GI bleeding to removing pre-cancerous polyps, banding oesophageal varices, dilating strictures, and placing stents — therapeutic endoscopy has replaced what used to require major open surgery for a large number of digestive conditions. Recovery is faster. Risk is lower. And in most cases, the patient goes home the same day or the next morning.
Dr. Sushrut Singh completed a fellowship in Advanced Therapeutic Endoscopy under Dr. Malay Sharma — one of India’s most recognised experts in therapeutic endoscopy. He performs the full range of these procedures at Fortis Hospital, Noida, backed by a dedicated endoscopy team, fluoroscopy facilities, and the hospital’s intensive care support for complex or emergency cases.
What Is Advanced Therapeutic Endoscopy?
Standard endoscopy is diagnostic — the doctor looks, assesses, takes biopsies if needed, and gives you a report.
Therapeutic endoscopy goes further. The endoscope becomes a treatment tool. Through the same flexible tube, specialised instruments can be passed to cut, burn, band, inject, stitch, dilate, clip, or remove tissue — all from inside the digestive tract, with no external wound.
The word "advanced" matters here. Basic therapeutic endoscopy includes simple procedures like biopsy or small polyp removal. Advanced therapeutic endoscopy covers the technically complex procedures — variceal management, haemostasis for active bleeding, stenting, large polypectomy, and more — that require dedicated fellowship training and high procedural volumes to perform safely.
Advanced Therapeutic Endoscopy Procedures Performed by Dr. Sushrut Singh
1. Variceal Band Ligation (EVL) — Banding of Oesophageal Varices
Oesophageal varices are dangerously enlarged veins that develop in the oesophagus of patients with liver cirrhosis and portal hypertension. When they rupture and bleed, it is a medical emergency — with a high risk of death if not treated immediately.
Variceal Band Ligation (EVL) places small elastic rubber bands around each varix through the endoscope, cutting off its blood supply. The banded varix dies and falls off within days, leaving a small scar. This is the gold standard treatment for both active variceal bleeding and prevention of first bleed in high-risk cirrhosis patients.
2. Sclerotherapy for Oesophageal Varices
A sclerosant chemical agent is injected directly into the varix through the endoscope, causing it to clot and obliterate. Used as an alternative to banding in certain situations, or as an adjunct to EVL when varices persist or recur. Dr. Sushrut performs both depending on the clinical situation and the characteristics of the varices being treated.
3. Glue Injection for Gastric Varices
Gastric varices — enlarged veins in the stomach wall — are technically more challenging to treat than oesophageal varices and carry a higher bleeding risk. The standard endoscopic treatment is cyanoacrylate (tissue glue) injection, which forms an immediate cast inside the varix, stopping bleeding and obliterating the vessel. This requires precise technique and is performed routinely by Dr. Sushrut at Fortis Noida.
4. Polypectomy — Colon and Gastric Polyp Removal
Polyps in the colon or stomach are abnormal tissue growths that can be pre-cancerous or cancerous. Polypectomy removes them entirely during the endoscopy or colonoscopy session itself — using a snare, forceps, or specialised resection technique depending on the size and type of polyp. The removed tissue is sent to the pathology lab for analysis. No separate surgical procedure needed.
Polypectomy is the single most effective intervention available for preventing colorectal cancer — removing polyps before they have the chance to become malignant.
5. Endoscopic Haemostasis — Stopping Active GI Bleeding
Active bleeding from peptic ulcers, vascular malformations, post-procedural sites, or tumours is treated endoscopically using a combination of techniques:
- Injection therapy — adrenaline injected around the bleeding vessel to cause vasoconstriction and tamponade
- Haemoclipping — metal clips applied directly over the bleeding vessel to mechanically seal it
- Thermal coagulation — heat applied through a probe to coagulate the bleeding site
- Argon Plasma Coagulation (APC) — ionised argon gas delivers controlled thermal energy to destroy abnormal bleeding tissue
Active GI bleeding is one of the most urgent scenarios in gastroenterology. Dr. Sushrut's training covers the full range of haemostasis techniques — and Fortis Hospital's endoscopy suite is equipped for emergency procedures.
6. Stricture Dilatation — Oesophageal, Pyloric & Duodenal
Strictures are abnormal narrowings in the digestive tract that make swallowing difficult or block food from passing through the stomach. They can be caused by peptic ulcer scarring, caustic injury, post-surgical narrowing, radiation damage, or cancer.
Endoscopic dilatation uses a balloon or bougie dilator passed through the endoscope to stretch the narrowed segment open — restoring normal swallowing and gastric emptying without surgery. In many cases, the procedure needs to be repeated at intervals to maintain the opening.
7. Oesophageal and Enteral Stenting
For strictures that cannot be maintained by dilatation alone — particularly malignant strictures caused by oesophageal, gastric, or duodenal cancer — self-expanding metal stents (SEMS) are placed through the endoscope to hold the narrowed segment open permanently. This restores the ability to eat and swallow in patients who would otherwise be unable to, significantly improving quality of life in advanced disease.
8. Foreign Body Removal
Swallowed foreign objects — fish bones, coins, food bolus impaction, dental prostheses, batteries, and others — are removed endoscopically using specialised retrieval forceps, nets, or extraction devices. Prompt endoscopic removal prevents perforation, infection, and injury. Food bolus impaction in the oesophagus is a common emergency that requires urgent endoscopic clearance.
9. Argon Plasma Coagulation (APC)
APC uses a jet of ionised argon gas to deliver controlled thermal energy through the endoscope to destroy abnormal tissue. Used for:
- Angiodysplasia — small abnormal blood vessels in the GI tract that cause chronic bleeding
- Gastric Antral Vascular Ectasia (GAVE / Watermelon Stomach) — a condition causing persistent GI blood loss
- Residual polyp tissue after polypectomy
- Radiation-induced bowel changes causing bleeding
10. Percutaneous Endoscopic Gastrostomy (PEG)
For patients who cannot swallow safely due to stroke, neurological disease, head and neck cancer, or prolonged illness — a PEG tube provides long-term nutritional access directly into the stomach. The tube is placed through the abdominal wall under endoscopic guidance, without open surgery. PEG feeding significantly improves nutritional status and quality of life in patients who cannot eat orally.
Why Advanced Therapeutic Endoscopy Requires a Specialist
Not every gastroenterologist performs advanced therapeutic endoscopy. The difference between a doctor who does standard diagnostic endoscopy and one who performs the procedures above is significant — and it matters for patient safety and outcomes.
Dedicated Fellowship Training
Beyond the standard gastroenterology DM curriculum — a separate, focused fellowship in advanced therapeutic endoscopy is required.
High Case Volumes
Particularly for variceal management, active bleeding, and complex polypectomy — proficiency is built through sustained, high-volume practice.
Specialised Equipment
The right instruments, fluoroscopy where needed, and a trained endoscopy support team — all working together in a dedicated suite.
Emergency Backup Capability
Intensive care and surgical support for the rare cases that need it — available at Fortis Hospital, Noida.
Dr. Sushrut Singh brings all of this to his patients at Fortis Hospital, Noida — fellowship-trained, high-volume practice, fully equipped endoscopy suite, and a multidisciplinary team.
Why Advanced Therapeutic Endoscopy Requires a Specialist
Not every gastroenterologist performs advanced therapeutic endoscopy. The difference between a doctor who does standard diagnostic endoscopy and one who performs the procedures above is significant — and it matters for patient safety and outcomes.
Dedicated Fellowship Training
Beyond the standard gastroenterology DM curriculum — a separate, focused fellowship in advanced therapeutic endoscopy is required.
High Case Volumes
Particularly for variceal management, active bleeding, and complex polypectomy — proficiency is built through sustained, high-volume practice.
Specialised Equipment
The right instruments, fluoroscopy where needed, and a trained endoscopy support team — all working together in a dedicated suite.
Emergency Backup Capability
Intensive care and surgical support for the rare cases that need it — available at Fortis Hospital, Noida.
Dr. Sushrut Singh brings all of this to his patients at Fortis Hospital, Noida — fellowship-trained, high-volume practice, fully equipped endoscopy suite, and a multidisciplinary team.
Frequently Asked Questions — Advanced Therapeutic Endoscopy
Diagnostic endoscopy examines the digestive tract to identify a problem — it looks and reports. Therapeutic endoscopy treats the problem found — it acts. Many procedures combine both in a single session: the problem is identified and treated without the patient needing to come back for a second procedure.
In experienced hands at a well-equipped facility, therapeutic endoscopy is safe and highly effective. The risk profile varies by procedure — polypectomy and variceal banding carry different considerations than emergency haemostasis or stent placement. Dr. Sushrut will explain the specific risks relevant to your procedure clearly during the pre-procedure consultation.
Most patients require 2–4 sessions of EVL, spaced 2–4 weeks apart, to achieve complete obliteration of varices. After that, surveillance endoscopy is performed every 3–6 months to check for recurrence. The schedule is personalised based on the severity of your liver disease and variceal findings.
Yes — definitively. Colorectal cancer almost always develops from pre-existing polyps over a period of years. Removing polyps during colonoscopy before they become malignant is the most effective strategy for colorectal cancer prevention. Patients with polyps found and removed are placed on a surveillance colonoscopy schedule based on the number, size, and type of polyps removed.
Yes. Fortis Hospital, Noida has endoscopy facilities available for urgent cases including active GI bleeding. If you or a family member is experiencing symptoms of acute GI bleeding — vomiting blood, black tarry stools, or sudden significant rectal bleeding — go to the Fortis Hospital emergency department or call immediately.
Possibly yes — this depends on whether varices are present and their size. Current guidelines recommend screening endoscopy for all patients with confirmed cirrhosis to assess for varices. If medium or large varices are found, prophylactic banding (before any bleed occurs) significantly reduces the risk of a first haemorrhage. Dr. Sushrut will advise based on your endoscopy findings and overall liver disease status.