Northside Hospital Gwinnett has expanded its Interventional Gastrointestinal (GI) Endoscopy Program with a series of new, minimally invasive procedures that are available in Gwinnett County and surrounding communities.
Third-space endoscopy provides organ-preserving treatment options for patients who otherwise may require surgery resection to address precancerous lesions or early cancers of the esophagus, stomach, small intestine or colon.
These procedures are also options for GI conditions such as gastroparesis, achalasia and Zenker’s diverticulum—conditions often debilitating movement or structural disorders of the GI tract, leading to chronic and severe dysphagia (difficulty swallowing), nausea and vomiting.
How it’s done: Also known as submucosal endoscopy, procedures are performed via endoscopy or colonoscopy within the “third space” of the GI tract — the space between the inner lining and muscle layers of the GI tract — without any cuts on the skin.
A long and flexible tube with a camera at its end (endoscope) is guided through the digestive tract to the area of interest. Once the camera is in place, an endoscopic knife is used to make precise incisions from the inside of the GI tract. This allows access to areas previously difficult to reach without more invasive techniques.
Third-space procedures are minimally invasive and typically involve less discomfort and recovery time than traditional surgeries, making them a preferred choice for many patients. Patients go home within a few hours.The first third-space procedures were successfully performed at Northside Gwinnett on April 17 and included:
- Esophageal and Zenker’s per-oral endoscopic myotomy (POEM) to treat severe swallowing troubles due to achalasia and Zenker’s diverticula.
- Endoscopic submucosal dissection (ESD) with complete removal of pre-cancerous lesions of the stomach and colon.


