Northside Gwinnett launches new ‘third space’ GI endoscopy

Third space endoscopy

Northside Hospital Gwinnett has expanded its Interventional Gastrointestinal (GI) Endoscopy Program with a series of new, minimally invasive procedures that are available for the first time 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 an innovative and reliable treatment option 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.

What they’re saying: “These techniques offer alternatives to more invasive surgical procedures and, in most cases, are performed as outpatient, requiring very little recovery time,” said Dr. Justin J. Forde, advanced endoscopist. “They expand treatment options for patients who have medical issues that may not make them a good candidate for surgery or for those who want to avoid more invasive surgical procedures.”

“These techniques require extensive training and are typically only available at large academic centers, which can pose accessibility issues for patients,” Dr. Forde added. “We are very excited to be able to offer these treatment options in the community setting at Northside Gwinnett.”
  • “Third-space endoscopy procedures are an outstanding addition to our advanced, interventional GI program at Northside Hospital Gwinnett,” said Jamie Wessels, BSN, R.N., interventional nurse navigator. “Our third space procedures provide life-changing results without having to undergo surgery; we’re pleased to be able to offer POEM and ESD to the Atlanta area.”

Next steps: To make a referral or to find a provider, call 678-312-3874.

Learn more about advanced GI diagnosis and treatment at Northside. 

Pictured (from left: Jamie Wessels, R.N., interventional nurse navigator, Northside Hospital Gwinnett; Jalina Ramey, interventional GI tech, Northside Hospital Gwinnett; Charles Clendenin, territory manager, Olympus; Justin Forde, M.D., advanced endoscopist; and Karen Richards, R.N., endoscopy nurse, Northside Hospital Gwinnett. 


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Dr. Justin Forde picture

Dr. Justin Forde

Specialties: Gastroenterology, Interventional Gastroenterology

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Dr. Justin Forde is board-certified in internal medicine, gastroenterology and obesity medicine. He received dedicated training in third-space endoscopy, including peroral endoscopy myotomy (POEM) and endoscopic submucosal dissection (ESD), in addition to bariatric endoscopy, EUS and ERCP.  

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