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Interventional Endoscopy
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 67 reviews
by Anonymous on Interventional Endoscopy

My experience in having the POEM procedure through IES Medical Group with Dr. Kenneth Binmoeller was completely wonderful. It was a miracle. Prior to having the procedure, I was diagnosed with achalasia and had been experiencing worsening symptoms my whole adult life, beginning with hiccups, and progressing to a point where I couldn't swallow anything at all, except for liquids.

The facilities at California Pacific Medical Center were great, and the quality of care I received from my doctor and staff was excellent. Dr Binmoeller thoroughly explained everything they would do, and did do, and I felt completely informed throughout the process. As soon as the next day I felt relief. I have continued to experience relief from my achalasia symptoms since I underwent the POEM procedure nearly a year and one half ago.

by Anonymous on Interventional Endoscopy
POEM Review

Prior to having my peroral endoscopic myotomy, or POEM, I was diagnosed with achalasia type III and was living with severe and worsening symptoms. Eating and drinking were becoming extremely difficult and even while doing so carefully I was still experiencing choking at least once per week. Just drinking water had become dangerous for me- it was so difficult to swallow it could get into my lungs and cause aspiration pneumonia. Over the years, I have had aspiration pneumonia about ten times. I was also starting to develop painful esopogeal spasms. I had dozens of surgical procedures to address other medical issues and therefore I didn't want to go through any more traditional surgeries.

I elected to have the POEM procedure through IES Medical Group at California Pacific Medical Center in San Francisco. The hospital's facilities were nice and new. My performing physician, Dr. Andrew Nett, was great to work with- he is very sharp and knowledgeable. Post-procedure, the medical staff monitored my progress. The only issue I had was inhaling a small amount of fluid during the surgery. It cleared up as they said it would, in about 1-3 days. As soon as about two weeks after my procedure, I was able to swallow much better.

It's been nearly two years since having my POEM performed and I am still enjoying relief from my symptoms and a better quality of life. I have achieved a healthy weight and am now able to eat and drink whatever I want. It is amazing how something once so difficult has now become so normal. I would definitely recommend this procedure to others who have had similar experiences, and as a good alternative to surgically based treatments.

by Anonymous on Interventional Endoscopy

I am very happy with the care I received through IES Medical Group. I love the entire staff- whenever I call, they are so pleasant. I've had multiple procedures completed there over the last few years, including endoscopic cryotherapy in 2018 with Dr. Kenneth Binmoeller, and c-TIF, or concomitant laparoscopic hiatal hernia repair with TIF, performed in 2019 by Dr. Andrew Nett and Dr. Jossart. Now, over a year later, I am still experiencing positive symptom relief and continue to use this office for my endoscopic needs. I've had nothing but good experiences related to it.

by Anonymous on Interventional Endoscopy

I thought I'd share my story in the hopes it may be helpful to others. I'm 55 so my doctors had reminded me yearly since I was 50 to get my colonoscopy done. I had finally set a goal of having my dreaded first colonoscopy by the end of last year and scheduled it in mid December 2015. I thought I had developed hemorrhoids in the prior 6 - 8 months thus prompting me in finally getting it scheduled. I let my gastroenterologist Dr. Mrudula Kumar know right before the procedure to let me know if I had any options to remove them etc. To my surprise the colonoscopy determined I didn't have hemorrhoids, instead I had a large flat polyp along with many small flat ones very near my rectum. Dr Kumar left them alone and said normally these would require surgery and due to the proximity of the polyps could have a good chance in resulting in a colostomy bag. I'm stunned...what!? However, she told me here in the SF area we are lucky to have Dr. Binmoeller's IES group so I could see if his new endoscopy procedures available there will work for my situation. I immediately called Dr. Binmoeller's office and was setup for a mid March procedure after getting all the paper work transferred. I didn't see Dr. Binmoeller until minutes before my procedure and I can say he didn't mince words at all....he was very direct and honest telling me how serious my situation was and if there is any sign of cancer the procedure will end without doing anything. There would be a new plan made which would end with me having a colostomy bag! He promised me he would do all he could and he was the best to do this. I took one last look at my husband with tears in my eyes. Before I went out I thought I'm putting everything into this technique he pioneered and certainly hoped I caught this before there was any cancer. Following the procedure I met with Dr. Binmoeller who was sincerely happy to let me know the procedure was a success! He was very confident there was no cancer, which was later confirmed through pathology results. I was even back to work the next day - amazing technology! I'm so thankful Dr kumar told me about Dr. Binmoeller's group and I'm extremely grateful beyond words on what Dr. Binmoeller did for me. I so dodged a bullet! Listen to your doctor and get your first colonoscopy when you turn 50. If you find you have large flat polyps needing surgery seek out Dr. Binmoeller's IES group as it may be your answer. I can never thank Dr. Binmoeller enough, without his work I'd be having a very different life right now.

by Anonymous on Interventional Endoscopy

Having turned 50 recently, I had a routine colonoscopy and found to have a polyp on old appendix scar. My options were surgery vs endoscopic resection of the polyp. Being an anesthesiologist , I have worked with Dr. Binmoeller for many years and watched him expertly remove polyp in numerous cases in which it was not feasible by other endoscopists or would have required surgery. Thus, my decision was very easy. I had Dr. Binmoeller remove the polyp from my old appendix scar. Next day I was able to return to provide anesthesia for Dr. Binmoeller patients. This would not have been possible if I had surgery. My advise to anyone reading this blog is that you should get a second opinion from Dr. Binmoeller prior to your colon or gastric surgery.

by Anonymous on Interventional Endoscopy


I was referred to Dr. Binmoeller from my Kaiser doctor because my polyp wasn't ordinary. It was large, flat and dark, (later found to be precancerous). It was also located at the end of my colon. My symptoms were almost constant diarrhea and weight loss but the tests showed no intestinal infections. A colonoscopy was ordered and that is when the Kaiser doctor found the polyp.



I was told, (time flies when you are under anesthesia), that Dr. Binmoeller's surgery took between two and three hours but he was able to completely remove the polyp.



I was so very fortunate that Dr. Moezardalan, from Kaiser realized what was there and then referred me to Dr. Binmoeller. This really struck home when I found out that had this procedure not been successful I would now have a colostomy bag. THANK YOU!, for every thing that you did.

by Anonymous on Interventional Endoscopy

Like a number of men my age now 72 I started getting Colonoscopy exams at the age of 50. I had a few older friends who never were checked until it was too late. I started seeing Dr Jonathan Leichtling at age 50 and continued being checked every 5 years till the age of 66. About 3 years ago I was experiencing some stomach discomfort and was referred to Dr Annette Kwon who suggested she do a colonoscopy even though my next one was another 2 years off. Dr Kwon found a number of polyps which she removed in addition she found a flat 10mm polyp. Dr. Kwon referred me to her colleague Dr. Kenneth Binmoeller who pioneered flat polyp surgery. I was lucky to live in a part of the country where medical advancements take place. In May of 2015 Dr. Binmoeller successfully removed my 10mm flat polyp. I just today completed my second followup checkup in 3 years with no recurrence. My thanks to Dr. Binmoeller and staff for the excellent work they do.

by Anonymous on Interventional Endoscopy

I was referred to surgeon for removal of 1/3 of my colon after a flat polyp was found in cecum. All path reports after colonoscopy were normal. I read Jim Sease's blog and started looking for a doctor on the east coast. Luckily I found Dr. Wallace at Mayo Hospital in Jacksonville, FL. Had the procedure done on Tuesday, went back to motel and spent the night, and then drove home . Thank you for spreading the word.

by Anonymous on Interventional Endoscopy

I am 34 year old indian.having many polyps (>50) in the rectum and sigmoid.Few Diminutive polyps (15-20) involving caccum, ascending,transverse and descending colon. my Doctor advice Proctocolectomy and oleo-anal pouch . I just wated to know that this can be treated with Endoscopic Mucosal Resection (EMR) Methos.

by Anonymous on Interventional Endoscopy

Like everyone else found my way to Dr. Binmoeller after fighting off those who would like to remove half a colon plus a removal of part of the cecum that missed the polyp. sigh Dr. Binmoeller was able to resect the reluctant and much abused polyp and I am a happy camper.


Am giving this a 5 star for all the professionals encountered here, with Dr. Binmoeller at the pinnacle of excellence.


Difficult getting thru to the schedulers at times as many others have noted.

by Anonymous on Interventional Endoscopy

Two years ago I had a colonoscopy with a youngish GI Dr.. in Medford, Oregon. He found a "20mm tubular adenoma polyp" in the "appendiceal orifice" in the cecum and said it could not be removed due to the thin wall in that area...and he referred me to a surgeon in a local group. When I researched the surgeon on line however I discovered that there had been some litigation about her "inadvertently" attaching a colon to a vagina. So I called the GI doc back and told him and he said to pick another from the group...which I did. He also averred that it would only require a small resection of the cecum and that he had dyed the area. Three months later I had the surgery and while there was dye in the specimen...there was no polyp .. Fortunately I had adamantly told the surgeon prior to surgery I was NOT to have a hemi-colectomy, so he did not keep chomping away on the cecum. I was stymied as to what to do next and had lost all faith in the system I was in. So the next Spring (no snow on the mountain passes) I made the 6 hr auto trip and returned to my old stomping ground in California and my previous GI doc in Marin, Dr. Sowerby, did a colonoscopy and confirmed the presence of said polyp and then referred my to Dr. Binmoeller at CPMC in SF. Dr. Sowerby said: "Every patient he had referred to Dr. Binmoeller had had a successful outcome" which was quite reassuring at this point. Long story short in Sept 2017 Dr. Binmoeller performed a colonoscopy with his advanced methods and expertise and removed the polyp and advised a check up in 6 months. Unbelievable that more doctors are unaware of his method. I am hoping to rectify that here in Southern Oregon....and make sure that at least all the doctors I encountered hear about him.

by Anonymous on Interventional Endoscopy

Five stars for Dr. Binmoeller and his medical staff for excellent and proffessional work throughout the procedures. I was referred here following a diaganostic colonoscopy which found a large and difficult lesion. He was able to remove it completely while keeping all the surrounding tissue intact. Reportedly other surgeons might have done a more severe colonectomy (I did not receive a second opinion, so can't confirm this myself.) The follow-up exam months later reveal complete recovery. One star off for the difficult time I had with the office staff scheduling the appointments and reaching them for follow-up issues. But they did acknowledge the problems, and report that they will be making changes to the relevant procedures to improve this. While I hope that I don't have to return here for medical issues, I wish them all success.

by Anonymous on Interventional Endoscopy

I just realized how fortunate I was to get to know Dr. Binmoeller and his Interventional Endoscopy Services early this year when I found out there was a 4cm polyps in my colon from a routine colonoscopy exam. At that difficult time, my GI and family doctors suggested that I should schedule an open abdominal surgery to remove the polyps even though the biopsy report showed that it’s a benign polyp. My doctors said the biopsy only examined the superficial fiber tissues of the polyps and could not determine if it was cancerous and that having open abdominal surgery to remove the polyps was the most thorough and secure way to clear out all the suspected cancer cells. I was very concerned. I was not totally convinced and doubted why the removal of a benign polyp would require an open abdominal surgery. So I went to seek 2nd doctor’s opinion. Fortunately, I was referred to see Dr. Binmoller and learnt that through a non-invasive way known as Colonoscopy with EMR can remove the polyps. When I searched on the web about the non-invasive method, I learned that Dr. Binmoeller is the founder of Interventional Endoscopy Services (IES) at California Pacific Medical Center. He is a renowned doctor in this field with over 20 years’ experience. He has improved this surgery to a more advanced level, for example, he uses a very delicate technique called underwater technique which uses water instead of gas to fill the colon during the procedure. This provides enhanced patient comfort and is much safer. I felt so lucky that I could have such a famous doctor to perform this procedure on me. On the procedure day, what I needed to do was fast for one day before the examination. I was very nervous when I laid on the operating table. Dr. Binmoeller told me not to worry and explained how this method was more beneficial than an open abdominal surgery. His confident attitude eliminated my stress. When I woke up in the recovery room one hour later, I didn’t feel any abdominal pain nor discomfort. The nurse assured me that the polyp had been successfully removed and I would receive the biopsy report in a few days. When I drove back home, all I felt was relief and gratefulness. I had my first bowl movement 3 days after the procedure. I was a little anxious but it was very smooth with no signs of blood. I was totally relieved. Then I returned to my normal routine of running 3 miles a day in just 3 days after the EMR procedure. Dr. Binmoeller brought me the great news after the pathology report was done that the polyp had been removed entirely and it’s not cancerous. No one would understand how grateful I am to Dr. Binmoeller. To have an open abdominal surgery may have long-term adverse health effect and would have negative impact on my health and quality of life for rest of my life. That’s why I am eager to share my story to others and let others know Dr. Binmoeller saved my colon, and let me regain my quality of life. The risk of colorectal cancer in the Chinese population is higher than other ethnic groups. If we don’t remove polyps at its early stage, there is a higher risk that it will turn cancerous. I have the urgency to share my story with more people and to let them know that even a big polyp can be removed by new type of colonoscopy with EMR. I also wanted to let others know that our life is in our hands. We should get a second opinion whenever we are in doubt. I also hope that more medical professionals can be more open minded to new technology, have patients’ wellbeing in mind and promote a newer, safer medical method to benefit more patients just like Dr. Binmoeller did. As the Chinese saying goes, better save one life than build a seven-story pagoda. This is the main reason why I am sharing my story. I want to do a good deed for others.

by Anonymous on Interventional Endoscopy

After a routine colonoscopy in my hometown of Seattle, the Colonoscopy physician removed two polyps. Fortunately, being a very capable physician, he did not try to remove the 30mm flat polyp in the cecum, as that procedure needed further discussion since it was a more difficult procedure. He told me he would try to take it out and when I asked what was his success rate for this type of removal, he said about 85%. Being in healthcare for 40 years, I decided to do some more research. In that research I found Dr. Binmoeller. I spent hours reading about him on line, reading his reviews, his papers and studies, watched his videos and then spoke to him via phone. He explained his procedure, which was very different from the procedure described by my original Colonoscopy physician. He also told me he has a 99%+ success rate and he usually has to fix the procedures of other physicians trying to take out polyps like the long flat one I had. The day of the procedure, while prepping he met with me and went into detail about the procedure. I had the procedure done in January and as he predicted, it was uneventful. Recovery was easy and there were no side effects or problems. He even discovered one smaller, flat polyp missed on the original Colonoscopy. Dr. Binmoeller is a dedicated professional. He is what every physician should strive to be like. There are two rules for those of us who were or are in the "healthcare" system : 1-Stay out of the "healthcare" system by making the right lifestyle choices. Rule #2-if you have to go into the "healthcare" system, make sure you are in the hands of the top physician/surgeon in that speciality. Dr. Binmoeller is the best Endoscopic surgery physician there is......PERIOD!

by Anonymous on Interventional Endoscopy

My story is one of success. First, my dad died of colon cancer in 1995 at the age of 78. I am now 70 years old. My story starts at about age 50. I was having a pain in my lower right abdomen. I went to the doctor and was sent for a Barium enema. Soon after I was told something was found. A colonoscopy was scheduled and 10+ polyps were found and removed. Compared to what I see today the polyps removed at that time were large. One that I passed at home was about the size of a small pecan. Another colonoscopy was scheduled for six months and was described as a clean-up procedure. Fewer polyps were found. The next colonoscopy was for two years. The colonoscopies over the next nine or 10 years was performed by a doctor in Roseville CA. After this 10 year period, I started to feel my doctor didn’t have a real concern for me and my health. I was just another patient. I then went to Doctor R in Folsom CA. I liked him. He seemed up to date on procedures, he seemed truly concerned about me and my health. After the colonoscopy Dr. R told me he had removed many polyps successfully but there was one flat polyp that he didn’t touch. He took pictures of the polyp, and identified the location. He suggested I go to the doctors at Interventional Endoscopy Services (IES) at California Pacific Medical Center (CPMC) or UC Davis. I asked the obvious questions of why he couldn’t remove the flat polyp and why the other two centers could remove them. He told me they have advanced tools and techniques. Doctor R did not touch the flat polyp during my procedure. Thank goodness he did not try. Next he suggested I go to the IES/CPMC. I took his advice and made the appointment with Dr. Binmoeller. This was lucky event (finding Dr. Binmoeller) in my journey with polyps. After my first colonoscopy with Dr. Binmoeller, he indicated he had successfully removed the flat polyp and removed 12 more. I have gone to Dr. Binmoeller each year for the last three years and I go back in March of this year. I now live in Portland OR and I travel to San Francisco for the procedure. I do this without a second thought. I know that the polyps are removed and when a flat one is encountered, I know I have best chance of having it removed successfully. Unfortunately, polyps continue to grow in me and I have to go back each year for a colonoscopy. Dr. Binmoeller has suggested that I be tested to determine if that I am missing the gene that suppresses the growth of polyps. He then suggested that my three daughters are tested also. Not that polyps can be prevented but that my daughters will be aware of the missing gene and can be aware and schedule colonoscopies to prevent polyps from developing and becoming cancerous. My last words, I have been lucky. Lucky in the sense that I was able to find Dr. R who led me to Dr. Binmoeller. Dr. Binmoeller is a God-Send for me. You just know he has skills beyond other doctors in his field of medicine. I realize Dr. Binmoeller has been showing his tools and teaching his advanced techniques to others, but Dr. Binmoeller has been the one who has added years to my life. After each procedure he sits down with my wife and me and talks to us for as long as we have questions. He doesn’t rush us. Something that has always bugged me was a question, i.e. will “C” catch up with me? He answered absolutely not, you just have to stay in front of it with colonoscopies as needed. He has a staff who shows a lot of respect and understanding for the patient. My advice to anyone who is dealing with colonoscopies and polyps is to make sure you have a doctor who understands the risks of removing flat polyps and what happens if they are not completely removed. The resulting scar tissue and the downside of living with a polyp that can’t be removed, and what might have to happen as a result, is a terrible price to pay when it can be prevented. In the event you ever have to deal with what I have been describing, I highly recommend Dr. Kenneth Binmoeller or one of the doctors at IES/CPMC in San Francisco, CA. Dr. Binmoeller has added years to my life and I am so thankful to him for this gift.

by Anonymous on Interventional Endoscopy

Dr. Kenneth, Thank you for saving my colon! We appreciated spending time with Erika & I enlightening us on Endovision.

by Anonymous on Interventional Endoscopy

Flat polyp removal was done by Dr. Binmoeller during a colonoscopy procedure using EMR with fantastic results. I was back at work the next day. Another GI doctor had me scheduled with a surgeon who was going to pull my colon out and try to cut it out with a scalpel - which would have required multiple procedures with a long recover time and uncertain long term side effects. Found Dr. Binmoeller through a yelp review, not by referal from my GI doctor.


Best Gastroenterologist in the San Francisco Bay Area!

by Anonymous on Interventional Endoscopy

A few months ago I learned an incredibly valuable lesson that I hope everyone reading this can learn from as well. I had a large flat polyp that was biopsied. The biopsy left scar tissue. As I came to know, scar tissue is a possible blocker to being able to remove flat polyps without surgery. This put me at high risk of needing to have surgery that would end my quality of life. At the beginning of my procedure, Dr. Binmoeller mentioned that scar tissue from biopsy could be prohibitive to removing a flat polyp using endoscopic mucosal resection. I was very worried he would not be able to remove the polyp. In addition to the scar tissue, I knew from previous doctors that the edges of my polyp were not easily defined and the depth was unknown. This alone even for the most skilled physician made my case a very difficult one. Dr. Binmoeller was not only able to define the edges, but he successfully removed the entire polyp despite the extreme difficulty of the scar tissue. I am beyond grateful to Dr. Binmoeller. If I had had surgery, it would have resulted in a colostomy. I cannot express my relief, gratitude, and good fortune in finding Dr. Binmoeller. I love to dance, play tennis, and run. My quality of life would have been severely diminished had I gone through surgery. I have a new lease on life and urge anyone with a condition similar to mine see Dr. Binmoeller. He can do things nobody else can. I am eternally grateful he has dedicated his life to helping people with conditions such as mine. As far as I am concerned, he is a miracle worker. His entire team is among the best I have ever seen at any hospital. I would like to thank them all. What an amazing group of professionals.

by Anonymous on Interventional Endoscopy

It all started with my first screening colonoscopy in Phoenix AZ on 7/21/2015. As I was waking up from anesthesia my doctor informed me that I have a 3cm flat polyp that he could not remove and would require surgery. I was in shock as I was trying to absorb the news and trying to cope with everything around me at the same time. I was referred to a surgeon and upon my visit he gave me a brochure that has all the different types of colon surgery and mine was a right hemicolectomy and was informed by the surgeon that I would require a few days stay at the hospital after surgery and a few more weeks to recover. This did not sound too good and I started to panic as I scheduled for surgery but also began researching the Internet for other options. I found out about EMR (Endoscopic Mucosal Resection) and began reading about it. After I was convinced that the EMR procedure was a viable option I looked for an EMR specialist around where I live and I found a specialist in Chandler and immediately scheduled for consultation. Upon consultation the specialist informed me that he will attempt an EMR and removal of the flat polyp but if he encounters any difficulties during the procedure he will stop and I agreed. I immediately cancelled my surgery and scheduled for an EMR procedure in the hope that the polyp will be removed without having to take out almost one foot of my colon. The day came for my second colonoscopy "EMR" on 9/16/2015 and I was nervous but was hoping that the doctor will be successful in removing the entire flat polyp. I was informed after the procedure that the polyp was too big and spanned over two folds in my colon making it difficult to remove with EMR and the specialist referred me back to surgery as the only remaining option. All that was done in the second attempt was a lift performed on a specimen sent for histology to evaluate for possible underlying malignancy (which thankfully came back clean). At that point I was extremely disappointed and rescheduled for surgery but in my mind I felt that EMR was still a viable option so I went back and did more research. I found out that EMR is highly dependent on the skill of the doctor performing it, so it's important to find a doctor who is good and good EMR doctors are few. You might think it's important to find a doctor close to home. It might be possible but it's not necessarily easy and in my situation that was not the case. For EMR, I think the probability of success is more important than convenience. Remember good EMR doctors are few! Once again I started researching EMR specialists on the west coast and Dr Kenneth Binmoeller's name, from California Pacific Medical Center in San Fransisco, came up. I immediately contacted his office and sent all my reports and they came back saying that there is a good chance that Dr. Binmoeller can remove it so I went ahead and scheduled for the procedure and cancelled my surgery for the second time. I travelled to San Francisco with my wife the day before my procedure and started my usual liquid prep in the evening. The big day finally arrived on 11/20/2015, the day of my EMR procedure, I was feeling anxious but hopeful again that this time around the results will be different than previous attempts. Dr Binmoeller delivered the great news that the procedure was successfully performed but with great difficulty due to severe scarring of the tissue from the previous attempted EMR. I was extremely relieved and thankful for his expertise and ability to remove a difficult polyp en bloc (in one piece). In my dictionary Dr Binmoeller is the "Godfather of colonoscopy"!

by Anonymous on Interventional Endoscopy

"I turned 65, got medicare, and thought getting a colonoscopy would be a good idea. I made a living doing carpentry at Lake Tahoe, and only knew the basics about colonoscopy. A screening procedure to search for polyps that could cause colon cancer. I did my first colonoscopy without any sedative or anesthesia and I was fully aware during the procedure. “Doctor S” found a large flat polyp. He biopsied the polyp about 8 times. Then he withdrew the scope. But before completely removing the scope, he decided to go back up and tattoo the polyp so he could find it next time. I didn’t realize at the time, but he had just made 2 mistakes that will make the removal of the polyp harder. Biopsies and tattoos cause scarring. Polyps are easier to remove if they have not been fiddled with. The type of polyp he found was the dangerous (prone to turn cancerous ) type and also tough to remove. Our next meeting, Doctor S discussed the method of using a saline solution injected into the colon wall to lift the polyp off the colon wall so the polyp could be removed without perforating the colon wall. The abbreviation for this procedure is EMR. After the procedure Doctor S came out and said he got 90% of the polyp, and I should come back in a year to have the rest removed. I thought 90% was pretty good and 10% next year should be a piece of cake. I got interested in the technique used to remove a polyp, and started googling about the procedure called EMR. Eventually I stumbled on an article called “How i do it”, in which 3 doctors discuss their way to remove these difficult polyps (Google: “remove sessile polyp how I do it”). All 3 doctors said something similar to the following quote: “First and foremost, it is important to carefully assess the lesion to be removed. I will only attempt to resect a lesion endoscopically if I judge that it can be completely removed in a single procedure. Partial removal of a polyp is usually a disaster, leading to inevitable polyp regrowth over a “fixed” scar that may then prove impossible for resection at a later date. “ By incompletely resecting my polyp Doctor S sealed my fate and I may be left with no choice than to surgically remove 18” of colon. The reason removal is now problematic is because scar tissue will prevent a saline solution from raising the polyp up off the colon wall. Some doctors suggest that a saline solution will still work for a period of 2 months after, because the scar tissue has not formed yet. Well, I’m way past the 2 month window. Why am I finding this out now? Online? Doctor S said come back in 1 year. Looks like 2 more mistakes. Really big mistakes. I read many articles on EMR. Everyone said it must be removed 100% or big problems. It’s like skydiving and pulling the ripcord 90% - a bad outcome. Doctor S had made my situation much worse. The polyp now had a much greater chance of turning cancerous and would be much more difficult to remove. I was regretting ever getting a colonoscopy. The next year ( per instructions) I went to see Doctor S to discuss removing the last 10%. We talked about the surgery to be done and what if he could not remove the polyp. He said the surgery was “non invasive”, and it made me think of my eye cataract removal. It would be done in 1 day and I’d go home that night – or so I thought. His plan: Step 1: put scope in my colon , and look at the polyp, if he didn’t think he could remove it, then Step 2: I was going straight to surgery for the non invasive removal of the polyp. On the way out the door I asked him about possible scar tissue. “ I like scar tissue” was Doctor S’s response. So I went home and watched a youtube video of the non invasive surgery to remove the polyp. Wow, that was some video. Non invasive - B.S. Also, he forgot to mention 5 days in the hospital to recover. The next day I canceled the procedure with him. Doctor S had zero chance of removing a polyp that would be much harder on his second try. And the colon surgery done in such a rushed and unorganized manner did not appeal to me. If I got to do it, let's at least schedule the operation and let me find a home for my dog for 5 days. I started to call around to get another colon specialist to take a look. No luck. Maybe no one wanted to try to fix someone’s mistake? I started looking for doctors doing clinical tests in polyp removal. My search lead to the doctors at Interventional Endoscopy Services (IES) at CPMC. One of the IES doctors, Dr Hamerski, responded to my email and said he might be able to remove the polyp. He was willing to try. A major breakthrough for me. Dr. Hamerski removed the polyp in one piece. A new technique? Certainly one I hadn’t read about. Called “underwater EMR”, it was pioneered by Dr Binmoeller, the Director of IES. After the polyp removal Dr. Hamerski presented me with a pamphlet containing a 6 page report on the procedure he had done 45 minutes earlier. The report included 4 pages of photos, and an explanation of what the photos showed. Also, an ultrasound view of the tissue below the polyp. Dr. Hamerski said the ultrasound did not show signs of cancer. Ultrasound - I never read about that in polyp analyzing . Great idea. The pride the IES Team takes in their work was very evident. They seem to look forward to challenging polyps. They are writing the book on new and better ways of polyp removal. Thanks IES and Sutter Health CPMC for your effort. You prevented a risky surgery to remove the polyp by removing a section of my colon then stapling my colon back together. You have a much better solution! No 5 days in the hospital! I wish Doctor S had referred me to IES in the first place. That should have been his first and only action once he saw the polyp. I don’t get it. How can a carpenter go online and discover Doctor S has violated the cardinal rule for this procedure. The Rule: If you are not sure or not committed to removing 100%, then do nothing. Just as puzzling , is the fact that neither Doctor S or my General Practitioner referred me to IES. Lake Tahoe is only 200 miles from San Francisco. I found IES by a spur of the moment email I sent. The link to IES is: www.cpmc.org/ies."

by Anonymous on Interventional Endoscopy

My regular GI doc in Palo Alto discovered a "very large" flat polyp across a fold in my colon in a difficult position near the appendix. She referred me to Dr. Binmoeller, who performed an EMR procedure to remove the polyp. The previous method of dealing with this sort of polyp, which if left untreated would likely eventually develop into cancer, was to remove part of the colon. Needless to say, I am incredibly grateful to Dr. Binmoeller and his expert team at CPMC for the top-notch care they delivered. A follow-up procedure showed the operation to be a complete success, and I am a very grateful patient.

by Anonymous on Interventional Endoscopy

My story is like so many others, I went in for a routine colonoscopy at the age of 58. I put it off because I felt to busy & healthy to have this invasion to my body. When I spoke with the doctor after the procedure he let me know that I had a very large polypoid mass and he was unable to remove it, he wanted me to set up surgery and have it taken out. I asked if he would set up a referral for a second opinion. Thankfully this led me to Dr. Kenneth Binmoeller who threw his amazing expertise in this area was able to remove the lesion with colonoscopy intervention. My suggestion to all is get your 1st preventive care colonoscopy when your doctor suggest, usually at age 50. If there is something to large for them to remove have them leave it alone and ask them to not inject marker ink which can lead to scaring. Dr. Binmoeller let me know it is always sad to talk to a patient after their procedure and tell them that the lesion could not be removed because of prior attempts elsewhare that were unsuccessful, causing to much scar tissue to allow the endoscopy procedure. I am every thankful to have been lead to Dr. Binmoeller and his amazing team of providers. With Gratitude, Carolyn R.

by Anonymous on Interventional Endoscopy

Dr. Yasser Bhat performed a very challenging procedure on my sister. She has late stage cancer that caused an obstruction of her large bowel. Dr. Bhat successfully installed a colonic stent across three constrictions in a colon that was very tricky to navigate. Only the most expert and confident of physicians could have done this procedure. Due to the success of this intervention, my sister was able to get out of danger and ultimately go home. I can't thank Dr. Bhat enough for having the courage and skill to help my sister.

by Anonymous on Interventional Endoscopy

During my colonoscopy, a 10cm rectal polyp was discovered, and lucky for me, my Gastroenterologist in Petaluma referred me to a Gastroenterology surgeon in San Francisco. Once again, lucky for me, this surgeon, Laurence Yee, MD, in having his best interest in only his patient (me), said since the biopsies from my colonoscopy were benign, he would send me to another specialist, Kenneth Binmoeller, MD, to evaluate the polyp for cancer, using ultrasound, and remove it, using Interventional Endoscopy, thus saving me from losing my rectum, part of colon and greatly lowering my quality of life, for life. Dr. Binmoeller and his excellent team, accepted the challenge of removing this very difficult polyp (size and location in rectum created this challenge) and removal was a complete success!! My message is this, "Please don't accept surgery as the only alternative, Intervention Endoscopy can save you a lifetime of poor quality of life. Get a second opinion and have Dr. Binmoeller's team do an evaluation before you agree to invasive surgery!" Oh, by the way, 2 1/2 hours after my polyp removal, I stopped at StarBucks for coffee, and my wife & I walked around San Francisco, just enjoying the sites, pain free and beyond estatic! Thank you to my gastroenterologist, Dr. Steady, Dr. Laurence Yee, and Dr. Binmoeller and to your entire team, from appointment making Colleen and Rochelle, for getting my husband in quickly, to all the entire medical team….Clifford S, Petaluma, CA

by Anonymous on Interventional Endoscopy

I, like many of the others in the stories told in this blog, had an unusual lateral growth and could have ended up with a colostomy and a lesser quality of life. I was fortunate to be steered in the right direction and ended up at Dr. Binmoeller’s Interventional Endoscopy Center. Backtracking a bit (age 56), during a routine colonoscopy in 2010, my gastroenterologist found a laterally spreading polyp that he was unsuccessful in removing. He referred me to a surgeon who was also unsuccessful in removing it. Unfortunately, the surgeon did not tell me that he had left much of the polyp behind, and it continued to grow over the next 5 years to the next routine colonoscopy. Last year (age 61), I scheduled a colonoscopy with a different gastroenterologist, Dr. Levitt. After reviewing the paperwork from my previous 2 procedures, Dr. Levitt performed the colonoscopy and found a much larger laterally spreading polyp; pieces of it were 6 cm in length. Fortunately, Dr. Levitt knew of Dr. Binmoeller and his ground-breaking endoscopy procedures and he set up a referral. The following month, Dr. Binmoeller reviewed all previous procedures and informed me that due to the large amount of scar tissue, he may not be able to completely remove the mass. But, after a 2 hour endoscopic mucosal resection, Dr. Binmoeller happily reported that he thought he was able to remove it all. 2 weeks ago, I came back for a 6-month return check. There were still a few remaining small spots, which he removed, but overall everything looked healthy and clean of any growths. I will come back in 6 months for my final check-up and expect a clean bill of health. What I learned from this experience is that sometimes there are existing options of which your doctor may not be aware. When provided a solution that does not sound acceptable (such as a colostomy), check with other sources first to see if there are other options. Thank you, Dr. Binmoeller!!

by Anonymous on Interventional Endoscopy

My father is 75 years old. He suffered from stomach pains because of gallbladder stones last September. Usually the gallbladder can be removed with a common surgery. For a normal patient, this would be a safe and relatively easy surgery. But since my father has a serious heart disease and cirrhosis, removing his gallbladder becomes very dangerous. There’s a 50% chance he might die from such a common surgery, so the doctor had to put a temporary bag outside his body with a needle inserted into the gallbladder to dispose bile liquid. His quality of life was low with stones in his gallbladder and a bag hanging outside of his body. Fortunately, we met Dr. Merriman at CPMC. He referred my father to Dr. Binmoeller for an innovational procedure. Dr. Binmoeller installed the AXIOS stent (a wire mesh tube) between my father’s gallbladder and duodenum. The bile can flow back through this new channel. Also all the stones are cleaned through this tube. My father does not need the bag anymore. His quality of life has been greatly improved. Now he is much happier and healthier. We are grateful.

by Anonymous on Interventional Endoscopy

I was referred to Dr. Kenneth Binmoeller by my regular gastroenterologist Dr. Michael Verhille following my 2nd screening colonoscopy at age 61. I had outpatient surgery to remove a 3 cm precancerous (flat) polyp by his unique method of minimally invasive endoscopic mucosal resection in June 2015. Just had my 6 month follow up colononscopy and got an 'all clear'. I am grateful for Dr. Binmoeller's skill and thoughtful explanation of the issue. If you have a diagnosis such as this DO NOT HESITATE to seek out his service and hopefully you too will be able to avoid colon surgery. I know I dodged a bullet.

by Anonymous on Interventional Endoscopy


I was referred to Dr. Binmoeller from my Kaiser doctor because my polyp wasn't ordinary. It was large, flat and dark, (later found to be precancerous). It was also located at the end of my colon. My symptoms were almost constant diarrhea and weight loss but the tests showed no intestinal infections. A colonoscopy was ordered and that is when the Kaiser doctor found the polyp.



I was told, (time flies when you are under anesthesia), that Dr. Binmoeller's surgery took between two and three hours but he was able to completely remove the polyp.



I was so very fortunate that Dr. Moezardalan, from Kaiser realized what was there and then referred me to Dr. Binmoeller. This really struck home when I found out that had this procedure not been successful I would now have a colostomy bag. THANK YOU!, for every thing that you did.

by Anonymous on Interventional Endoscopy

A few months ago, I was diagnosed with several large, problematic colon polyps during a routine colonoscopy, and was thereafter referred to a surgeon to have them removed. I met with two surgeons, who both gave me the same bad news: that I needed either a partial colectomy. I am writing this with the intention of giving some insight to those who find themselves in a similar situation, in hopes that they may find my story beneficial (in particular, the route of treatment that I chose to pursue).

Procedures for non-surgical removal of colon polyps are not common knowledge to most patients. These non-surgical techniques are relatively new, and are only performed by a small number of gastroenterologists who have undergone specific training. While researching my options, I came across www.sease.com<http://www.sease.com/>, a website created by a patient named Jim Sease. I am incredibly thankful to him for creating this site, which is essentially a treatise on endoscopic mucosal resection (EMR), a type of non-surgical polyp removal. Further reading yielded the following article on a novel technique , called "Underwater EMR" developed by Dr Kenneth Binmoeller: http://www.jigjournal.org/sites/default/files/113-116%20%20JIG-2014.pdf , The above publication, among others, clarified for me the differences between two non-surgical techniques available to remove large, problematic colon polyps: the standard EMR versus the underwater EMR technique . EMR, in a nutshell, involves a physician using a rectal endoscope (basically a camera on a long wire through a narrow tube, with lights and instruments), to find and remove abnormal tissue from the colon. This holds true for both standard EMR and underwater EMR. So now let's look at the differences between the two techniques. Firstly, as its name would imply, underwater EMR is a procedure done "under water", while standard EMR is not. Let me explain: During standard EMR, the intestines are inflated with gas, which creates enough space for the surgeon to work inside, and allows them to search the colon for other abnormal tissue.

During Underwater EMR, on the other hand, gas is replaced by water. So instead of using gas to inflate the intestines, the surgeon uses saline (which is just water with salts in it), to create space to work within the colon. Basically, that's the "big" difference. But from this one change, there are a surprising number of advantages that are gained by using the underwater technique. First of all, the underwater technique allows the surgeon to see more clearly. You can watch videos that demonstrate this here: https://vimeo.com/69845248 But even more importantly, underwater EMR avoids the sub-mucosal injection that most standard EMR procedures involve.

The sub mucosal injection basically involves injecting saline near the abnormal tissue, in a very difficult place to inject: in between two very thin layers of tissue. Here are some of the problems associated with the submucosal injection used in the standard EMR ,that are avoided with Underwater EMR : 1). There is the risk of injecting saline too deep during submucosal injection. Like our skin, the lining of our colon has multiple layers. During the submucosal injection, what the doctor is trying to do is separate the top layer from the next one below it, so that it is easier to remove JUST the top layer. However, this is very difficult to do without pushing the needle too deep. Imagine you have a pizza -- many layers, with cheese on top of bread. Now using a needle, poke through the cheese so that you can squirt water IN BETWEEN the cheese and bread.

This will make the cheese rise up a little bit, and separate from the layer below it, making it easy to just go in and remove the cheese. HOWEVER, you could push the needle too far. Now you are injecting water into the bread, and both layers are puffed up. What this is saying is that if during that submucosal injection, they inject a bit too far (too deep), they will cause more than just the top layer of tissue to lift. Then, the snare (the cutting tool) will capture more tissue than just the abnormal outer layer. This defeats the purpose, which was to make the outer-most layer easy to remove! 2) There is a risk of infection during submucosal injection. Sometimes, due to a misdirected injection outside the bowel wall in standard EMR,there is a risk of infection at the injection site, a risk avoided using underwater EMR since there is no injection. 3) There is also the risk of "needle track seeding" at the injection site. There is the theoretical potential (and there is some evidence that this can happen) that the needle puncture itself can push abnormal cells deeper into the tissue! Think about it like this -- cells are SMALL. Almost as small as the tip of a needle. So when you push a needle into tissue, it takes a lot of cells with it (pushing them forward into deeper areas of tissue).

This is the same concept as why you wash a kiwi before cutting it. You don't eat the skin, but just by cutting through the kiwi, you can push germs from the skin into the meat, because they get pushed by the blade itself! Same concept here -- if there are abnormal cells on an outer layer, and you stick a needle through that layer, the needle can push some of those cells deeper into the tissue, where they can linger and grow, causing problems in the future. The risk of needle track seeding is entirely avoided using the Underwater EMR technique, since there is no submucosal injection involved! After reading all this, I chose to go with Underwater EMR, and had my procedure performed at CPMC in San Francisco by Dr Kenneth Binmoeller in December of 2015. My procedure couldn¹t have possibly gone better. My experience with the whole staff was comfortable and relaxed ‹ I felt that I was very well taken care of. As far as recovery, it was like nothing had ever happened. No pain, no discomfort, nothing! I was simply amazed at how smoothly my recovery went.

I had read in Jim Sease's blog ( www.sease.com<http://www.sease.com/>) about a short recovery period, with some discomfort and I was prepared to experience this. But from the moment I woke up from anesthesia, I felt as if no procedure was performed. I immediately resumed my normal activities ! As for Dr Binmoeller , words cannot describe this charismatic and gifted doctor ! It is less than common to encounter a doctor who combines such superior skills , knowledge, experience and zeal for advancement with warmth , confidence and kindness . One that makes you feel right away reassured that you made the best choice !

by Anonymous on Interventional Endoscopy

It all started with my first screening colonoscopy in Phoenix AZ on 7/21/2015. As I was waking up from anesthesia my doctor informed me that I have a 3cm flat polyp that he could not remove and would require surgery. I was in shock as I was trying to absorb the news and trying to cope with everything around me at the same time. I was referred to a surgeon and upon my visit he gave me a brochure that has all the different types of colon surgery and mine was a right hemicolectomy and was informed by the surgeon that I would require a few days stay at the hospital after surgery and a few more weeks to recover. This did not sound too good and I started to panic as I scheduled for surgery but also began researching the Internet for other options. I found out about EMR (Endoscopic Mucosal Resection) and began reading about it. After I was convinced that the EMR procedure was a viable option I looked for an EMR specialist around where I live and I found a specialist in Chandler and immediately scheduled for consultation. Upon consultation the specialist informed me that he will attempt an EMR and removal of the flat polyp but if he encounters any difficulties during the procedure he will stop and I agreed. I immediately cancelled my surgery and scheduled for an EMR procedure in the hope that the polyp will be removed without having to take out almost one foot of my colon. The day came for my second colonoscopy "EMR" on 9/16/2015 and I was nervous but was hoping that the doctor will be successful in removing the entire flat polyp. I was informed after the procedure that the polyp was too big and spanned over two folds in my colon making it difficult to remove with EMR and the specialist referred me back to surgery as the only remaining option. All that was done in the second attempt was a lift performed on a specimen sent for histology to evaluate for possible underlying malignancy (which thankfully came back clean). At that point I was extremely disappointed and rescheduled for surgery but in my mind I felt that EMR was still a viable option so I went back and did more research. I found out that EMR is highly dependent on the skill of the doctor performing it, so it's important to find a doctor who is good and good EMR doctors are few. You might think it’s important to find a doctor close to home. It might be possible but it’s not necessarily easy and in my situation that was not the case. For EMR, I think the probability of success is more important than convenience. Remember good EMR doctors are few! Once again I started researching EMR specialists on the west coast and Dr Kenneth Binmoeller's name, from California Pacific Medical Center in San Fransisco, came up. I immediately contacted his office and sent all my reports and they came back saying that there is a good chance that Dr. Binmoeller can remove it so I went ahead and scheduled for the procedure and cancelled my surgery for the second time. I travelled to San Fransisco with my wife the day before my procedure and started my usual liquid prep in the evening. The big day finally arrived on 11/20/2015, the day of my EMR procedure, I was feeling anxious but hopeful again that this time around the results will be different than previous attempts. Dr Binmoeller delivered the great news that the procedure was successfully performed but with great difficulty due to severe scarring of the tissue from the previous attempted EMR. I was extremely relieved and thankful for his expertise and ability to remove a difficult polyp en bloc (in one piece). In my dictionary Dr Binmoeller is the "Godfather of colonoscopy"!

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