Direct access endoscopy service at NSSDH

Doug 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")
Doug Performing Colonoscopy


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
Family history CRC Matrix
Family history 10 year absolute risk
Surveillance Intervals Colonoscopy