Caring for you as we would for ourselves

Center of Interventional Endoscopy La Tour (CIEL)

CIEL brings together all the expertise, equipment, and care pathways related to interventional gastrointestinal endoscopy. It aims to provide a clear, coordinated structure focused on delivering the most appropriate expertise for each clinical situation.

Our interventional gastrointestinal endoscopy service offers comprehensive and innovative care for gastrointestinal conditions, ranging from basic diagnostic exams to the most complex procedures.
 We are the only private facility in the canton of Geneva to offer the full range of these advanced procedures, providing patients with access to minimally invasive, precise, and safe treatments, regardless of their insurance status (basic, semi-private, private, or international insurance).

Our goal is to provide the least invasive care possible, under optimal safety conditions, without compromising cancer detection or resorting to overtreatment.

Complex procedures are generally discussed in advance by our multidisciplinary team: specialized gastroenterologists, anesthesiologists, gastrointestinal surgeons, radiologists, and intensive care units work together to ensure safety, comfort, and personalized care. A tailored treatment strategy is developed to suit each patient.

The techniques offered include:

  • Basic examinations: esophagogastroduodenoscopy, colonoscopy, and video capsule endoscopy
  • Advanced procedures:  
    • Pancreatobiliary: including echoendoscopy, ERCP and cholangioscopy, pancreatic radiofrequency ablation, and endoscopic ampullectomy
    • Luminal procedures:   including submucosal dissection, management of fistulas and strictures, gastrostomies and gastrojejunostomy extensions, endoscopic gastroenterostomy, endoscopic myotomies for achalasia or pylorospasm (POEM/G-POEM), endoscopic revision of gastric bypass (TORe), Zenker’s diverticulotomy
    • Other: mediastinal and pelvic punctures, internal drainage

On-call duties in gastroenterology and interventional endoscopy

La Tour Hospital has a gastroenterology on-call service provided by its six specialists. In addition, CIEL is establishing a dedicated interventional endoscopy on-call service, led by Dr. Pierre Guibert and Dr. En-Ling Leung Ki, available 24 hours a day, 7 days a week starting in January 2026 to manage urgent, semi-urgent, and complex gastrointestinal conditions.

To request this on-call service outside of business hours, please contact the emergency physician at Hôpital de La Tour (+41 22 719 63 97), who can assist with your care and, if necessary, refer you to the on-call gastroenterologist.

Esophagogastroduodenal Endoscopy (EGDE)

Examination of the Esophagus, Stomach, and Duodenum

An upper endoscopy allows for direct visualization of the upper digestive tract and enables intervention if necessary—for example, to stop bleeding or perform biopsies.

Benefits of EGDE

  • Accurate and rapid diagnosis
  • Ability to treat certain lesions immediately
  • Minimally invasive procedure with a quick recovery

Main Indications

  • Reflux, persistent pain, or heartburn
  • Screening for precancerous or cancerous lesions
  • Unexplained gastrointestinal bleeding or anemia
  • Monitoring of chronic gastric conditions

Colonoscopy

Examination of the Colon and Rectum

Used to screen for colorectal cancer, detect and remove polyps, investigate chronic inflammatory bowel diseases, and diagnose various types of colitis (ischemic, infectious, diverticular)

Benefits

  • Combined diagnosis and treatment
  • Polyp removal without surgery
  • Quick recovery

Main Indications

  • Colorectal cancer screening
  • Persistent bleeding or diarrhea
  • Monitoring of IBD

Endoscopic Submucosal Dissection (ESD)

Complete resection of tumor lesions in a single piece (no fragmentation).

Allows for the complete removal of superficial lesions in the esophagus, stomach, colon, or rectum without open surgery.

Benefits

  • Complete resection of precancerous lesions
  • Accurate histological follow-up
  • Minimally invasive procedure, rapid recovery

Main Indications

  • Precancerous or superficial cancerous lesions
  • Large polyps or those that are difficult to resect
  • Patients who are not candidates for surgery

Practitioner

Dr. Pierre Guibert

 

nterventional Echoendoscopy (IEE)

Diagnosis and treatment of hard-to-reach lesions.

Combines ultrasound and endoscopy to aspirate, drain, or treat deep masses and the biliary-pancreatic system. For example, endoscopic ultrasound-guided (EEI) procedures allow for complex biliary drainage, such as:

  • Hepatogastrostomy: a direct internal biliary shunt between the liver and the stomach, used in cases of biliary obstruction inaccessible to conventional ERCP.
  • Choledochoduodenostomy: a biliary shunt between the common bile duct and the duodenum.

These procedures offer a minimally invasive alternative to surgery, with precise control guided by endoscopic ultrasound.

Benefits

  • Precise access to deep lesions
  • Avoids surgery in many cases
  • Combined diagnosis and treatment
  • Rapid recovery and optimal safety

Main Indications

  • Pancreatic, lymph node, mediastinal, hepatic, or pelvic masses requiring aspiration or drainage
  • Complex biliary obstruction not accessible via ERCP
  • Targeted biopsies of submucosal or deep lesions

Practitioners

Dr. Pierre Guibert (including hepatogastrostomy)
Dr. En-Ling Leung Ki

 

Radiofrequency Ablation of the Biliary Tract and Pancreas Under Endoscopic Ultrasound Guidance

Targeted treatment of benign or low-grade malignant tumors

Applies localized heat to treat neuroendocrine or cystic tumors of the pancreas when surgery is not indicated.

Benefits

  • Local treatment without surgery
  • Reduction in functional symptoms
  • Minimally invasive, guided procedure

Main Indications

  • Benign or precancerous tumors of the bile ducts or pancreas, and endocrine tumors
  • Cystic lesions at risk of degeneration
  • Management of endocrine symptoms

ERCP / cholangioscopy

Diagnosis and Treatment of Biliary Tract and Pancreatic Disorders

Enables the removal of stones from the common bile duct, the treatment of strictures, and direct visualization of the biliary tract.

Benefits

  • Minimally invasive treatment of stones and strictures, particularly those caused by tumors
  • Accurate diagnosis using direct visualization via cholangioscopy
  • Avoids surgery

Main Indications

  • Gallstone Removal
  • Biliary Strictures
  • Monitoring and Diagnosis of the Biliary Tract

Endoscopic ampullectomy

Resection of Lesions in the Ampulla of Vater

This procedure allows for the removal of polyps and benign or precancerous lesions from the ampulla, thereby avoiding surgery.

Benefits

  • Complete resection
  • Minimally invasive procedure
  • Quick recovery

Main Indications

  • Ampullary polyps or adenomas
  • Benign or precancerous lesions

Practitioner

Dr. Pierre Guibert

 

Management of Gastrointestinal Fistulas and Stenoses

Reopening and Bypassing of the Digestive Tract

This procedure restores the digestive tract in cases of strictures or fistulas by placing esophageal, duodenal, or colonic stents. It may also include combined endoscopically guided procedures, depending on the complexity of the lesion.

Benefits

  • Rapid restoration of the digestive tract
  • Minimally invasive procedure
  • Often avoids surgery
  • Simplified post-procedure monitoring

Main Indications

  • Symptomatic gastrointestinal or biliary fistulas
  • Esophageal, duodenal, or colonic strictures
  • Patients at high surgical risk

Gastrostomies and gastrojejunostomy extensions

Nutritional Support and Direct Therapeutic Administration

The placement of percutaneous endoscopic gastrostomies (PEG) and gastrojejunostomy extensions provides direct nutritional support in cases of gastric intolerance or gastrointestinal obstruction, or for the administration of specific treatments, particularly in Parkinson’s disease.

Placement is performed using either the “pull” or “push” technique, with the insertion of either tubes or small gastrostomy buttons.

Benefits

  • Effective and safe nutritional support
  • Direct administration of specific treatments
  • Minimally invasive procedure
  • Simplified monitoring and follow-up

Main Indications

  • Gastric intolerance or gastrointestinal obstruction
  • Need for long-term enteral nutrition
  • Administration of targeted therapies

Endoscopic Gastroenteric Anastomosis (LAMS)

Creation of minimally invasive bypasses in the digestive tract, between the stomach and the intestine

Luminal apposition stent (LAMS) gastroenterostomy allows for the bypassing of a digestive obstruction, restoring normal passage and avoiding surgery.

Benefits

  • Avoids open surgery
  • Rapid restoration of the digestive tract
  • Targeted, minimally invasive procedure

Main Indications

  • Gastric or duodenal obstruction
  • Need for a minimally invasive gastrointestinal bypass
  • Complex situations requiring rapid and safe access

POEM / G-POEM 

Endoscopic myotomy of the esophagus or pylorus

  • POEM: incision of the esophageal muscle to treat achalasia, restoring normal food passage.
  • G-POEM: pyloric myotomy to improve gastric emptying in patients with pyloric dysfunction or gastroparesis.

Benefits

  • Minimally invasive procedure
  • Significant reduction in symptoms
  • Quick recovery

Main Indications

  • Esophageal achalasia (POEM)
  • Pyloric dysfunction or gastroparesis (G-POEM)

Practitioner

Dr. Pierre Guibert

 

Bariatric Endoscopy: TORe (Transoral Outlet Reduction)

A multidisciplinary approach is central to the management of obesity. Minimally invasive endoscopic techniques allow for internal suturing to reduce the size of the stomach (endoscopic sleeve gastrectomy) or the size of the anastomosis following gastric bypass surgery.
The TORe technique is currently offered at La Tour Hospital

Endoscopic reduction of the gastrojejunal anastomosis

Reduces the diameter of the anastomosis after gastric bypass surgery to correct weight regain or dumping syndrome.

Benefits

  • Avoids major surgery
  • Restores the original restriction
  • Minimally invasive procedure

Main Indications

  • Weight regain after gastric bypass
  • Dumping syndrome

Practitioner

Dr. En-Ling Leung Ki, M.D.

 

Endoscopic Diverticulotomy for Zenker's Diverticula

Endoscopic Sectioning of the Esophageal Septum

This procedure is used to treat symptomatic Zenker’s diverticula—which cause dysphagia, regurgitation, or chronic cough—by endoscopically sectioning the spastic cricopharyngeal muscle that forms the septum between the diverticulum and the esophagus.

Benefits

  • Minimally invasive procedure
  • Rapid restoration of swallowing function
  • Avoids open surgery

Main Indications

  • Symptomatic Zenker's diverticulum
  • Persistent dysphagia and regurgitation

Practitioner

Dr. Pierre Guibert

 

Related specialties

The secretarial office