Gastroenterology Department at Hospital La Paz: National Reference Center in Endoscopic Submucosal Dissection
A historic double recognition: National CSUR in ESD/EMR and SEPD Excellent Service. Here is what this means for you if you've ever heard about a "difficult polyp", a Barrett's esophagus or an early gastric lesion.
Hospital Universitario La Paz: National CSUR in endoscopic treatment of complex early digestive neoplasms.
TL;DR (quick summary)
What happened:
- • La Paz is now a National CSUR in endoscopic treatment of complex early gastrointestinal neoplasms (ESD/EMR).
- • And it's also an SEPD Excellent Service (the third hospital in Spain with this certification).
What it means for you:
- • Any patient in Spain can be referred there for ESD or EMR via SIFCO-CSUR.
- • More experience = more safety, fewer major surgeries and faster recovery.
Gastroenterology Department at Hospital La Paz: National Reference Center in Endoscopic Submucosal Dissection. That's not a catchy headline — it's an official designation by the Spanish Ministry of Health that places our unit among the few centers in Spain authorized to treat early lesions of the digestive tract using advanced endoscopic techniques. And, as if that weren't enough, the same month our department has also received the Excellent Service certification from the Spanish Society of Digestive Pathology (SEPD). Two medals in a few days. Let me explain what this means in plain English.
Quick index
The double recognition, in plain English
Imagine a restaurant earning two major food awards in the same week: one from the State ("official") and one from its own community of chefs ("peer-reviewed"). Well, that's exactly what has happened to a medical department. In April 2026, the Gastroenterology Department of Hospital Universitario La Paz received:
1. National CSUR (Ministry of Health)
Designation as a Center, Service or Unit of Reference of the Spanish National Health System for the Endoscopic treatment of complex early gastrointestinal neoplasms (CSUR 98).
2. SEPD Excellent Service
Certification granted on April 14, 2026 by the Spanish Society of Digestive Pathology. La Paz becomes the third hospital in Spain to achieve this distinction.
The official press release from the Community of Madrid sums it up well: the award recognizes "a comprehensive, highly specialized, patient-centered care model." And the numbers back it up: ~1,700 inpatient admissions per year, +57,000 outpatient consultations, ~30,000 endoscopic procedures and more than 1,200 e-consultations managed annually.
What is a CSUR and why it's a big deal
CSUR stands for Center, Service or Unit of Reference of the Spanish National Health System. It was created by Royal Decree 1302/2006 to ensure that any patient, no matter where they live in Spain, can access highly specialized techniques without having to navigate the system on their own. The idea is simple: concentrate expertise in a few centers with high volume, so they do a lot and do it very well.
For the first time ever, in November 2024, the Ministry of Health designated Digestive Endoscopy Units as CSUR in three areas: POEM (type III achalasia), EUS-guided biliopancreatic drainage and ESD/EMR for early neoplasms. You can read the full details on the official SEED page on CSUR in digestive endoscopy.
Practical translation
If your doctor finds a complex polyp, a Barrett's esophagus with dysplasia or a very early gastric cancer, they can request your referral to the CSUR through a process called SIFCO-CSUR. No bureaucratic battles, no need to move to Madrid: it's handled by the Admissions Department of your local hospital.
This recognition isn't given away for free. It comes after years of documented work: high procedural volume, published outcomes, complication rates below the expected benchmarks, multidisciplinary teamwork and ongoing training. In other words: hours and hours in the endoscopy room, many clinical sessions and a healthy obsession with getting it right.
ESD and EMR: the two stars of advanced endoscopy
Let's get to the point. If you've never heard of these, don't worry — you'll understand them in two minutes.
Endoscopic Mucosal Resection (EMR)
EMR lets us "peel off" flat or small lesions from the wall of the digestive tract from the inside, through the endoscope. We inject fluid under the lesion to lift it, and remove it with a snare. No scalpel, no scar. If you want a step-by-step walkthrough, check this internal guide: Endoscopic Mucosal Resection (EMR).
Endoscopic Submucosal Dissection (ESD)
The big sister. ESD allows us to remove larger, deeper lesions in one single piece, which is crucial for the pathologist to confirm whether everything has been removed. It's done using tiny electrical knives through the endoscope. It's technically demanding, but in many cases it replaces major surgery altogether. I brought this technique from my fellowship at the National Cancer Center in Tokyo (2013), and we perform it daily at La Paz. Full details here: Endoscopic Submucosal Dissection (ESD).
Where are these techniques used?
- Esophagus: Barrett's esophagus with dysplasia or very early cancer → see Barrett's Esophagus Treatment.
- Stomach: adenomas and early gastric cancer.
- Duodenum: duodenal adenomas (including ampullary lesions).
- Colon and rectum: complex polyps, laterally spreading tumors (LSTs) and very early colorectal cancer.
SEPD Excellent Service: the second medal
The Spanish Society of Digestive Pathology (SEPD) is the scientific society that brings together gastroenterology specialists in Spain. Its Excellent Service Certification is pioneering: it evaluates quality indicators, patient safety, outcomes, training and research, comparing services with each other to drive continuous improvement.
La Paz received this accreditation on April 14, 2026, becoming the third hospital in Spain to achieve it. You can read the official announcement on the SEPD website. It's not a decorative sticker: it certifies that the department audits itself with a magnifying glass, compares its data with other hospitals and never settles.
Bonus: La Paz's Inflammatory Bowel Disease Unit was already certified as excellent by GETECCU, and the department as a whole holds ISO 9001:2015 in quality management and UNE 179003:2013 in patient safety. Here, excellence is a habit, not a one-off.
The team behind the recognition
A hospital doesn't win awards by magic. Behind the scenes there are people who arrive early, stay late and discuss every case with the intensity of a championship final. The department is led by Dr. María Dolores Martín Arranz, Head of the Gastroenterology Department, and the endoscopy unit is run by Dr. Aurora Burgos García, Head of the Endoscopy Section.
Dr. María Dolores Martín Arranz
Head of the Gastroenterology Department
Dr. Aurora Burgos García
Head of the Endoscopy Section · Complex Endoscopy Team
Dr. Mariana Tavecchia
Complex Endoscopy Team
Dr. Eduardo Martín Arranz
Complex Endoscopy Team
Dr. Pedro de María Pallarés
Complex Endoscopy Team · ESD, POEM and minimally invasive techniques
Add to that a large team of physicians, specialized nurses, technicians, pathologists, radiologists, surgeons, oncologists and administrative staff. When a patient arrives with a complex early lesion, a multidisciplinary committee decides the best strategy for that specific case. That's what really makes the difference.
What does this mean for you as a patient?
What changes in your day-to-day
- • Less major surgery: many lesions that used to require surgery are now removed endoscopically, without scars and with discharge within 24–48 hours.
- • Better diagnostic accuracy: by removing the lesion in one single piece, the pathologist can confirm whether everything has been removed.
- • Nationwide access: whether you live in Seville, Bilbao or the Canary Islands, you can be referred as a CSUR patient.
- • Faster recovery: usually one or two nights in hospital and back to normal life within a few days.
If you've been told you have a difficult polyp, a Barrett's with dysplasia or a gastric lesion, I'll help you map out the plan.
FAQ: quick questions about the recognition
What is a CSUR and why does it matter that La Paz holds one in ESD?
A CSUR is a Center, Service or Unit of Reference recognized by the Spanish Ministry of Health for complex conditions. La Paz being a CSUR means any patient in Spain can be referred there for ESD or EMR under full public coverage.
What is endoscopic submucosal dissection (ESD)?
It's a technique that removes precancerous lesions or very early cancers of the digestive tract in one single piece, without surgery. It's done through the mouth or the anus under sedation.
What does being an SEPD Excellent Service mean?
It's the certification by the Spanish Society of Digestive Pathology acknowledging the highest standards of quality and patient safety. La Paz is the third hospital in Spain to receive it.
Can I be treated at La Paz even if I don't live in Madrid?
Yes. Your local hospital's Admissions Department can process a SIFCO-CSUR referral. It gives you access to ESD/EMR at La Paz without bureaucratic obstacles.
What is the difference between ESD and EMR?
EMR removes smaller or flat lesions, sometimes in fragments. ESD allows the removal of larger or deeper lesions in one single piece, improving pathology analysis and reducing recurrence.
Been diagnosed with a complex lesion and not sure what to do?
Bring your endoscopy report and your biopsies. In consultation we'll review whether ESD, EMR or another technique is your best option, and I'll help you navigate the care pathway.
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