Procedures

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Jayant P. Talreja, M.D.

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  • Primary Office Location: St. Mary’s Medical Office Building, 5855 Bremo Road, Suite 706, Richmond, VA 23226
  • Primary Hospital: St. Mary’s Hospital
  • Certifications: Board Certified in Gastroenterology, 2012, and Internal Medicine, 2009

Dr. Talreja is originally from Virginia Beach, VA. In 2002, he completed a Bachelor of Arts with distinction in Biology at the University of Virginia. In 2006, he attained his Doctor of Medicine at the Medical College of Virginia/VCU School of Medicine. He then went on to complete his Internship, Internal Medicine Residency, and Gastroenterology Fellowship at the University of Virginia. During his fellowship, he was selected as the 2010 Department of Medicine Fellow of the Year. In 2011, he was the recipient of the UVA McPherson Award for Excellence in Clinical Research and the international recipient of the Yang K. Chen Fellowship Program. He was selected as the 2011-2012 Chief Fellow and was the recipient of the Carl L. Berg Most Valuable Player Award in 2012.

Following his training at UVA, he was selected for an Advanced Endoscopy Fellowship at the Massachusetts General Hospital and Brigham & Women’s Hospital of Harvard Medical School , which he completed in June 2013.

Dr. Talreja’s areas of interest include gastro-esophageal reflux disease (GERD), Barrett’s esophagus, peptic ulcer disease, GI bleeding, difficulty swallowing, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), irritable bowel syndrome, changes in bowel habits, GI motility disorders, gastrointestinal polyps, disorders of the biliary tract and pancreas, liver diseases, and endoscopic management of GI cancers.  He has expertise in the following general and advanced endoscopic procedures:

 

  • Upper endoscopy (EGD)
  • Colonoscopy (including removal of small and large polyps)
  • Endoscopic retrograde Cholangio-pancreatography (ERCP)
  • Endoscopic Ultrasound (EUS) with fine needle aspiration
  • Endoscopic Mucosal Resection (EMR)
  • Radiofrequency Ablation of Barrett’s Esophagus (HALO)
  • EUS-guided fiducial placement into malignant lesions for targeting radiation therapy
  • Single-operator cholangioscopy and pancreatoscopy (SpyGlass)
  • Single-balloon enteroscopy
  • Endoluminal stent placement – esophageal, duodenal, colonic
  • Probe-based confocal laser endomicroscopy (Cellvizio)
  • Over-the-scope clip placement for leaks/perforations (Ovesco, Aponos pad-lock)
  • Bariatric endoscopy
  • Endoscopic feeding tube placement (PEG)
  • Endoscopic dilation with botox or steroid injection
  • Endoscopic BRAVO pH monitor placement
  • Video capsule endoscopy

In his free time, Dr. Talreja enjoys traveling, running, basketball, tennis, golf, visual arts, and reading.

J. Diego Baltodano, MD

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  • Primary location: Wadsworth-Midlothian Center

  • Primary hospital: Bon Secours St. Francis Hospital

  • Outpatient services: Virginia Endoscopy Group (Northside, Staples Mill Rd), and (Southside, Midlothian Plaza), St. Francis Hospital, St. Francis outpatient Johnston-Willis Hospital, Johnston-Willis outpatient, Chippenham Hospital, Chippenham outpatient

  • Certifications: Board Certified in Gastroenterology, 2008

Dr. Diego Baltodano has been with GSI since 2013. He received his Doctor of Medicine in 1999 from the Universidad de Costa Rica. He completed his internship and residency in internal medicine in 2003 at SUNY Upstate Medical University.

In 2008, he completed his fellowship in gastroenterology at SUNY Upstate Medical University, and since then he has practiced gastroenterology at the Hunter Holmes McGuire VA Medical Center in Richmond, Va. He is also an assistant professor of internal medicine and gastroenterology at VCU School of Medicine.

Souheil G. Abou-Assi, MD

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  • Primary location: St. Mary’s Medical Office Building

  • Primary hospital: Bon Secours St. Mary’s Hospital

  • Outpatient services: Virginia Endoscopy Group (Northside, Staples Mill Road), and (Southside, Midlothian Plaza), St. Mary’s Hospital, St. Mary’s outpatient

  • Certifications: Board Certified in Gastroenterology, 2001

Dr. Souheil Abou-Assi has been with GSI since 2006. A native of Abadieh, Lebanon, Souheil received his Bachelor of Science degree from College la Sagesse there. He attended Saint Joseph University in Beirut from 1988 to 1995, attaining his Doctor of Medicine degree. He then travelled to America and did his Internship in Internal Medicine at Robert Wood Johnson Medical School in Camden, New Jersey. He went on to complete his Residency there in 1998.

From 1998 to 2001, Dr. Abou-Assi trained at the Medical College of Virginia as a Fellow in Gastroenterology and Hepatology. He practiced at MCV and at McGuire Veteran’s Administration Medical Center as an assistant professor of medicine in Gastroenterology and Hepatology until the end of 2005. During his tenure at the VA, Dr. Abou-Assi served on the steering committee of the Advanced Clinic Access and also as the Director of GI/Hepatology outpatient services.

Dr. Abou-Assi became busy very quickly upon joining GSI in 2006; he has developed a loyal following of patients and a steady stream of new patient referrals. He is known for his boundless energy as well as his commitment to getting the most out of each day.

Dr. Abou-Assi’s areas of interest are general gastrointestinal disorders including endoscopy and colonoscopy, irritable bowel syndrome and inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), nutrition, liver diseases, endoscopic treatments of Barrett’s esophagus, endoscopic management of gastrointestinal cancers, endoscopic ultrasound, endoscopic retrograde cholangiopancreatogram (ERCP), pancreatic diseases (pancreas cysts, pancreas cancer, pancreatitis, and pseudocysts), bile duct strictures and stones and endoscopic removal of large polyps and early cancers.

Dr. Abou-Assi is an active member of the Medical Executive Committee and the Physician Excellence Committee of Saint Mary’s hospital.

Dr. Abou-Assi is fluent in three languages, English, Arabic and French. His hobbies and interests include biking, playing tennis, reading, traveling and fishing.

Henry M. Ellett, M.D.

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  • Primary Location: Wadsworth-Midlothian Center

  • Primary hospitals: Chippenham and Johnston-Willis hospitals

  • Outpatient services: Virginia Endoscopy Group (Southside, Midlothian Plaza), Johnston-Willis Hospital, Johnston-Willis outpatient, Chippenham Hospital, Chippenham outpatient

  • Certifications: Board Certified in Gastroenterology, 1993; recertified 2004

Dr. Henry Ellett, a Charlottesville, Va., native, received his B.A. from the University of Virginia in 1982 and went on to attain his M.D. at the Medical College of Virginia. He also did his internship, residency and fellowship in Gastroenterology at MCV before beginning private practice in 1993.

Dr. Ellett practiced Gastroenterology for nine years in the Metropolitan area before joining Gastrointestinal Specialists in 2002. He enjoys a very busy practice on the Southside of Richmond. His drive and enthusiasm set the fast pace for his practice.

William Thomas Brand Jr., MD

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  • Primary location: Forest Medical Plaza (at Henrico Doctor’s Hospital)

  • Primary hospital: Henrico Doctors Hospital – Forest

  • Outpatient services: Virginia Endoscopy Group (Northside, Staples Mill Road) and (Southside, Midlothian Plaza), Henrico Doctors (both Forest and Parham), Henrico Doctors’ ASC

  • Certifications: Board Certified in Gastroenterology, 1987

Dr. William Thomas Brand was born in Staunton, Va., and grew up in Roanoke, Va. He received his B.A. from the University of Virginia in 1976 and his M.D. at the Medical College of Virginia in 1980. Dr. Brand excelled academically, achieving membership in Phi Beta Kappa honor society and receiving the Robert C. Ryan Pathology Award in 1977.

He completed his Gastroenterology Fellowship at Walter Reed Army Medical Center from 1984-1986; this was followed by a year as Director of Gastrointestinal Endoscopy and a year as the Director of Gastroenterology Service at Eisenhower Army Medical Center. In recognition of his achievements while serving in the military, Dr. Brand was awarded an Army Commendation Medal and the Meritorious Service Medal.

He has served as the Chief of Staff at Henrico Doctors’ Hospital, and he currently serves as the Chairman of the Endoscopy Committee. GSI welcomed him into our practice in 1988, and since then he has been named one of the area’s “Top Docs” so often we have lost count.

Dr. Brand’s interests include music, travel, UVA sports, and Virginia history. His wife, Lisa, has been active with The Richmond Academy of Medicine Alliance and with the Council of the Virginia Museum of Fine Arts.

Halo

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What is a HALO Procedure?

A HALO radiofrequency ablation procedure is a minimally invasive endoscopic procedure used to treat patients with Barrett’s Esophagus with dysplasia. Barrett’s Esophagus is a change in the type of esophageal tissue that regrows in place of esophageal tissue that is damaged by acid reflux. Not everyone that has reflux symptoms has Barrett’s Esophagus; however, if one develops Barrett’s Esophagus there is a chance of developing esophageal cancer. This depends on the degree of progression of the underlying Barrett’s Esophagus – low grade dysplasia vs. high grade dysplasia.

Leaving Barrett’s Esophagus with dysplasia untreated can increase your risk for developing esophageal cancer later in life. The HALO procedure is strongly recommended in the case of Barrett’s Esophagus because of its 98.4% success rate in removing the diseased tissues and at a 5-year follow up, 92% of patients remained disease-free.

In this procedure, directed and controlled heat energy is used to eliminate the damaged esophageal tissue that results in Barrett’s Esophagus while leaving the healthy tissues undamaged. New, healthier tissue grows back in place of the removed damaged tissues. The length of the Barrett’s Esophagus segment and each individual’s response to the radiofrequency ablation will determine how many treatments will be needed (on average 3-5 treatments for a long segment).

Before the HALO procedure, you will be asked to not eat or drink anything. If treating a short segment of Barrett’s Esophagus, the HALO procedure lasts around 30 minutes to ablate the diseased tissue through heat energy that emits from a device that is attached to or passed through the endoscope. If a longer segment is present, the HALO device is advanced into the esophagus and the same time of controlled and directed heat treatment is applied with the scope along side the device. Since it is a minimally invasive procedure, the patient will be under monitored anesthesia care throughout the process. No incisions are made.

There are very few limitations to consider post-procedure. Although you will not be impaired from the procedure, you will need someone to take you home and you are advised to take the day off from work. You should not operate heavy machinery, including driving. You may notice some soreness over the next few days, but you can return to your normal daily activities the day after the HALO procedure. Try to eat softer foods for about a week after your procedure.

HALO Procedure Side Effects

Although the HALO procedure is considered very safe and minimally invasive, there are risks associated with any procedure. Patients may experience the following HALO side effects:

  • Chest discomfort
  • Sore throat
  • Difficulty swallowing for a few days
  • Can provide medication
  • Mucosal laceration or perforation
  • Infection
  • Narrowing of the esophagus (rare)
  • Minor acute bleeding

If the pain persists, your doctor can prescribe a medication to relieve the pain post-procedure. However, it is unlikely that you will experience much pain besides soreness in your throat.

Do you have symptoms of acid reflux? Contact us today to set up an appointment with one of our physicians for a consultation.