Therapeutic Endoscopy

Therapeutic Endoscopy & Standard Endoscopy

Therapeutic endoscopy goes uses specialised tools through the endoscope to treat problems during the same procedure.

Standard endoscopy is designed to look and diagnose.

Benefits of therapeutic endoscopy include:

Treating the cause, not just identifying it
Fewer procedures and hospital visits
No external incisions; typically faster recovery
Seamless escalation to surgery if it’s needed

As a surgeon–interventional endoscopist, A/Prof Michael Talbot offers both endoscopic and surgical options in one team, so treatment is tailored, not one-size-fits-all.

Endoscopy used to be mainly for diagnosis. Now we can diagnose and treat early cancers during the same procedure. We can remove early oesophageal tumours endoscopically. Twenty years ago, that would have meant a big cut in the chest.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

ERCP combines upper endoscopy with X-ray to diagnose and treat disorders of the bile and pancreatic ducts.

It is used to:

Remove bile-duct stones (whether formed in the ducts or slipped from the gallbladder)
Treat some causes of pancreatitis (e.g., stones, strictures)
Diagnose and start treatment for pancreatic, biliary and duodenal cancers (e.g., stent placement to relieve obstruction)

Typical therapies during ERCP may include sphincterotomy (a precise cut to open the bile duct), balloon/basket stone extraction, stricture dilation and stent insertion to restore drainage.

POEM (Per-Oral Endoscopic Myotomy) for Achalasia

OEM is an incisionless endoscopic alternative to Heller myotomy that treats achalasia by dividing the tight muscle fibres of the lower oesophagus from inside the oesophageal wall.

Often preferred for complex disease or recurrent/persistent symptoms
Procedure time is typically 1-2 hours; average hospital stay is a couple of days
Risks are similar to Heller myotomy; selection is individualised to anatomy, physiology and patient goals

Other Advanced Therapeutic Endoscopy

Depending on the problem, A/Prof Talbot also utilises advanced endoscopic techniques to manage early oesophageal and gastric neoplasms and select upper GI complications, providing minimally invasive options that can reduce the need for open surgery.

Who Is It For?

People with obstructive jaundice, biliary pancreatitis or suspected bile-duct stones
Patients with achalasia or complex oesophageal motility disorders
Selected patients with early upper-GI cancers suitable for endoscopic therapy Your work-up (endoscopy, imaging, high-resolution physiology where relevant) ensures the treatment offered addresses the actual driver of symptoms.

What To Expect

Most therapeutic endoscopy procedures are done under sedation or general anaesthesia.

ERCP is usually a day-only or an overnight stay; POEM typically involves 2 days in the hospital. You’ll receive clear guidance on preparation, diet progression (for POEM), activity and follow-up.

Risks & Considerations

All procedures carry risk (e.g., bleeding, infection).

ERCP-specific risks include pancreatitis, perforation and bleeding; POEM risks include leak, bleeding and post-procedure reflux. Careful pre-procedure testing and expert techniques are used to minimise these risks and select the option with the best benefit-to-risk profile for you.

I was one of the first surgeons in NSW using endoscopy to treat early oesophageal and gastric cancers.

Why Choose Upper GI Surgery?

Dual skill set - specialist Upper GI surgeon and interventional endoscopist, providing endoscopic and surgical options.
High-volume expertise - extensive experience with ERCP, POEM and advanced therapeutic endoscopy
Precision diagnostics - NSW’s longest-established high-resolution oesophageal physiology lab to guide truly targeted care
Right treatment, right timing - endoscopic therapy when it’s best; surgical repair when it’s safer or more durable

Ready to take the next step?

If you’ve been told you need ERCP or you’re seeking a less invasive option for achalasia, book a consultation to discuss the therapeutic endoscopy approach that fits your condition and goals.

Upper GI Surgery
Suite 3 Level 5 1 South St,
Kogarah NSW 2217

P: 02 9553 1120
F: 02 9553 7526
E: info@uppergisurgery.com.au

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Therapeutic Endoscopy