Direct access endoscopy service at NSSDH
- Same day consultation and procedure at NSSDH
- Experienced GI trained nurses and anaesthetic team
- Rapid priority access with direct to procedure scheduling
- Immediate reports via Argus/Fax
- No gap for patients on Government Concession cards (DVA, Pensioner, Health Care Card)
- Cost effective terms for uninsured
- Perioperative support with senior nurse
- Recall register for patient follow up reminders
- NSSDH's on site free parking
where possible please write "direct access" - on your referral letter - to let our admin team know that we have your authority to schedule your patient for this service
Direct access procedures:
- Gastroscopy
- Flexible sigmoidoscopy
- Colonoscopy
- Haemorrhoid rubber band ligation (RBL) or infrared coagulation (IRC)
- Oesophageal dilatation
- Double balloon enteroscopy
- Capsule endoscopy
- Rapid iron infusion ("Ferinject"/"Monofer")
Common Indications*
- Positive FOBT
- Family history CRC or polyps
- Personal history of neoplastic polyps
- Rectal bleeding or bowel habit change > 6/52
- Surveillance and screening CRC
- dyspepsia or GORD > 60 or with alarm symptoms
- Coeliac disease diagnosis and follow up
- Barrett’s oesophagus screening or surveillance
Patient Suitability
- Low anaesthetic risk with no major organ disease
- Low bleeding risk:
- patients can continue aspirin or dipyridamole (unless on them for primary prevention)
- patients with authority to safely substitute aspirin for potent antiplatelets (clopidogrel, prasugrel, abciximab, ticagrelor) for 1 week prior
- Not suitable for:
- frail, elderly patients or
- those with more complex health issues or
- patients on insulin (who would find perioperative insulin management challenging)
- high bleeding/thrombosis risk patients on anticoagulants: where unclear if:
- safe to substitute aspirin for potent antiplatelets
- cardiologist may need consultation to temporarily stop
- bridging anticoagulation might be needed
