Surgical Endoscopy

, Volume 22, Issue 6, pp 1533–1546 | Cite as

Advanced endoscopic technologies

New Technology

Abstract

The use of endoscopy for diagnosing and treating ailments of the alimentary tract has evolved steadily over the past few decades, with tremendous growth and innovation in the past few years. Initially, endoscopy relied on rigid telescopes, direct visualization, and dangerously exothermic sources of illumination. The introduction of fiber optics, charge-coupled-device cameras, and increasingly efficient light sources has enabled researchers to investigate areas of the human gastrointestinal tract through flexible endoscopy not previously thought to be reachable without formal surgical exploration. The more recent advances in scope platforms, devices, and techniques have allowed researchers to push the envelope of endoscopic diagnostics and therapeutics to greater heights. Specific new platforms include ColonoSight and mother–daughter endoscopes such as the ShapeLock TransPort and the SpyGlass direct visualization system. Specific devices include the EndoCinch suturing system, the full-thickness Plicator procedure, Esophyx, the Stretta system, and the HALO360 system. Specific new techniques include small-caliber endoscopy, endoscopic mucosal and submucosal resection, and natural orifice translumenal endoscopic surgery (NOTES). This article describes the most relevant recent advances in endoscopic innovation with regard to platform design, devices, and techniques anticipated to serve as the foundation for further research and design for developing generations of endoscopic technologies to come.

Keywords

Endoscopy GERD NOTES ColonoSight ShapeLock SpyGlass EndoCinch Plicator Esophyx Stretta Halo Mucosal resection 

References

  1. 1.
    News release from NGN Capital (2006) http://www.ngncapital.com/index2.htm. Accessed at 6 Sep. 2006
  2. 2.
    Fireman Z (2005) New technology–Colono Sight®. Presentation at the OMED Colorectal Cancer Screening Meeting. May 14–19, 2005, Chicago, IL, USAGoogle Scholar
  3. 3.
    Shike M (2004) Major advances in colonoscopic technology: the ColonoSight®, a pull-power-assisted disposable, non-fiber optic colonoscope. Digestive Dis Week Abstract 102221Google Scholar
  4. 4.
    Food and Drug Administration (2005) USGI ShapeLock™ Endoscopic Guide product reviewGoogle Scholar
  5. 5.
    Kozarek R, Schembre D, Spaulding W et al (2005) Initial application of the ShapeLock endoscopic guide for small bowel enteroscopy. Gastrointest Endosc 61:AB172CrossRefGoogle Scholar
  6. 6.
    Swain P, Ewers R, Peh R, Sadaat V (2005) New measurement methods and a randomized comparison of force transmission using flexible endoscopes and instruments before and after the application of ShapeLock™ technology. Gastrointest Endosc 61:AB241CrossRefGoogle Scholar
  7. 7.
    Nierengarten MB (2006) Technology being tested by NOTES. Gen Surg News 33:10Google Scholar
  8. 8.
    Pai RD, Carr-Locke DL, Thompson CC (2006) Endoscopic evaluation of the defunctionalized stomach using ShapeLock technology. Gastrointest Endosc 63:AB88CrossRefGoogle Scholar
  9. 9.
    Swanstrom LL, Kozarek R, Pasricha PJ et al (2005) Development of a new access device for transgastric surgery. J Gastrointest Surg 9:1129–1136PubMedCrossRefGoogle Scholar
  10. 10.
    Rex DK, Khashab M, Raju GS, Pasricha J, Kozarek R (2005) Insertability and safety of a shape-locking device for colonoscopy. Am J Gastroenterol 100:817–820PubMedCrossRefGoogle Scholar
  11. 11.
    Haber G, Pasricha PJ (2005) The ShapeLock endoscopic guide facilitates successful colonoscopies after previously failed attempts in difficult cases. Gastrointest Endosc 61:AB263CrossRefGoogle Scholar
  12. 12.
    Food and Drug Administration (2005) SpyGlass™ direct visualization probe product reviewGoogle Scholar
  13. 13.
    Paul D (2006) Study shows that SpyGlass™ direct visualization system may alter ERCP diagnosis and treatment strategy. http://www.bostonscientific.mediaroom.com. Press release, accessed at 22 Mar. 2006
  14. 14.
    Paul D (2006) Cholangioscopy procedure with SpyGlass™ system description. http://www.bostonscientific.com. Accessed at 1 Nov. 2006
  15. 15.
    (2006) http://www.endocinch.com/. Accessed at 1 Nov. 2006
  16. 16.
    Filipi CJ, Lehman GA, Rothstein RI et al (2001) Transoral, flexible endoscopic suturing for treatment of GERD: a multicenter trial. Gastrointest Endosc 53:416–422PubMedCrossRefGoogle Scholar
  17. 17.
    Schwartz MP, Schwartz MP, Welllink H et al (2006) Endoscopic gastroplication for the treatment of gastro-oesophageal reflux disease: a randomised, sham-controlled trial. Gut 56:20–28PubMedCrossRefGoogle Scholar
  18. 18.
    Schiefke I, Zabel-Langhennig A, Neumann S, Feisthammel J, Moessner J, Caca K (2005) Long-term failure of endoscopic gastroplication (EndoCinchTM). Gut 54:752–758PubMedCrossRefGoogle Scholar
  19. 19.
    Mahmood Z, Byrne PJ, McMahon BP et al (2006) Comparison of transesophageal endoscopic plication (TEP) with laparoscopic Nissen fundoplication (LNF) in the treatment of uncomplicated reflux disease. Am J Gastroenterol 101:431–436PubMedCrossRefGoogle Scholar
  20. 20.
    Pleskow D, Rothstein R, Lo S (2004) Endoscopic full-thickness plication for the treatment of GERD: a multicenter trial. Gastrointest Endosc 59:163–171PubMedCrossRefGoogle Scholar
  21. 21.
    http://www.ndosurgical.com. Accessed at 1 Nov. 2006
  22. 22.
    Pleskow D, Rothstein R, Lo S et al (2005) Endoscopic full-thickness plication for the treatment of GERD: 12-month follow-up for the North American open-label trial. Gastrointest Endosc 61(6):643–649CrossRefGoogle Scholar
  23. 23.
    Lin E, Smith CD (2005) Objective improvements following full-thickness gastric cardia plication for complicated GERD. SAGES: Abstract S040Google Scholar
  24. 24.
    Rothstein R, Filipi C, Caca K et al (2006) Endoscopic full-thickness plication for the treatment of gastroesophageal reflux disease: a randomized, sham-controlled trial. Gastroenterology 131:704–712PubMedCrossRefGoogle Scholar
  25. 25.
    Cadière GB, Rajan A, Dapri G (2006) Nouvelle technique du traitement par voie endoscopique du reflux gastro-oesophagien: la fundoplicature endoluminale. J Coelio-chirurgie 57Google Scholar
  26. 26.
    (2006) EndoGastric Solutions™ announces 80% success rate of their endoluminal fundoplication (ELF) procedure using the EsophyX™ device. http://www.medicalnewstoday.com/medicalnews.php?newsid=58461. Press Release, accessed at 8 Dec. 2006
  27. 27.
  28. 28.
    Richards WO, Houston HL, Torquati A et al (2003) Paradigm shift in the management of gastroesophageal reflux disease. Ann Surg 237:638–647PubMedCrossRefGoogle Scholar
  29. 29.
    Go MR, Dundon JM, Karlowicz DJ et al (2004) Delivery of radiofrequency energy to the lower esophageal sphincter improves symptoms of gastroesophageal reflux. Surgery 136:786–794PubMedCrossRefGoogle Scholar
  30. 30.
    Mattar SG, Qureshi F, Taylor D, Schauer PR (2006) Treatment of refractory gastroesophageal reflux disease with radiofrequency energy (Stretta) in patients after Roux-en-Y gastric bypass. Surg Endosc 20:850–854PubMedCrossRefGoogle Scholar
  31. 31.
    Torquati A, Houston HL, Kaiser J, Holzman MD, Richards WO (2004) Long-term follow-up study of the Stretta procedure for the treatment of gastroesophageal reflux disease. Surg Endosc 18:1475–1479PubMedCrossRefGoogle Scholar
  32. 32.
    Triadafilopoulos G (2004) Changes in GERD symptom scores correlate with improvement in esophageal acid exposure after the Stretta procedure. Surg Endosc 18:1038–1044PubMedCrossRefGoogle Scholar
  33. 33.
    Yeh RW, Triadafilopoulos G (2005) Endoscopic antireflux therapy: the Stretta procedure. Thorac Surg Clin 15:395–403PubMedCrossRefGoogle Scholar
  34. 34.
  35. 35.
    Dunkin BJ, Martinez J, Bejarano PA et al (2006) Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device. Surg Endosc 20:125–130PubMedCrossRefGoogle Scholar
  36. 36.
    Bergman JJ, Sondermeijer C, Peters FP, Ten Kate FJ, Fockens P (2006) Balloon-based radiofrequency ablation of Barrett’s esophagus in patients with low-grade dysplasia or high-grade dysplasia with and without a prior endoscopic resection using the HALO360 ablation system. Gastrointest Endosc 63(4):AB137–AB138CrossRefGoogle Scholar
  37. 37.
    Bergman JJ, Sondermeijer C, Peters FP, Ten Kate FJ, Fockens P (2006) Circumferential balloon-based radiofrequency ablation of Barrett’s esophagus using the HALO360 ablation system preserves the inner diameter of the esophagus and prevents subsequent narrowing and compliance reduction. Gastrointestinal Endosc 63:AB138CrossRefGoogle Scholar
  38. 38.
    Fleischer DE, Sharma V, Reymunde A, et al (2006) Circumferential RF ablation for nondysplastic Barrett’s esophagus (NDBE) using the HALO360 ablation system (AIM) trial: one-year follow-up of 100 patients. Gastrointest Endosc 63:AB127CrossRefGoogle Scholar
  39. 39.
    Kim CY, O’Rourke RW, Chang EY, Jobe BA (2006) Unsedated small-caliber upper endoscopy: an emerging diagnostic and therapeutic technology. Surg Innovation 13:31–39CrossRefGoogle Scholar
  40. 40.
    Jobe BA, Hunter JG, Chang EY et al (2006) Office-based unsedated small-caliber endoscopy is equivalent to conventional sedated endoscopy in screening and surveillance for Barrett’s esophagus: a randomized and blinded comparison. Am J Gastroenterol 101:2693–2703PubMedCrossRefGoogle Scholar
  41. 41.
    Pungpapong S, Keaveny AP, Raimondo M et al (2006) Accuracy and degree of interobserver agreement of small-caliber endoscope in screening for esophageal varices. Gastrointest Endosc 63:AB121CrossRefGoogle Scholar
  42. 42.
    Yagi J, Adachi K, Arima N et al (2005) A prospective randomized comparative study on the safety and tolerability of transnasal esophagogastroduodenoscopy. Endoscopy 37:1226–1231PubMedCrossRefGoogle Scholar
  43. 43.
    Park CH, Lee WS, Joo YE et al (2006) Sedation-free colonoscopy using an upper endoscope is tolerable and effective in patients with low body mass index: a prospective randomized study. Am J Gastroenterol 101:2504–2510PubMedCrossRefGoogle Scholar
  44. 44.
    O’Connor JJ (2006) Screening endoscopy: cost effective? J Am Coll Surg 203:973PubMedCrossRefGoogle Scholar
  45. 45.
    Deprez PH, Aouattah T, Piessevaux H (2006) Endoscopic removal or ablation of oesophageal and gastric superficial tumours. Acta Gastroenterol Belg 69:304–311PubMedGoogle Scholar
  46. 46.
    Ross A, Larghi A, Stearns L et al (2006) Complete Barrett’s eradication endoscopic mucosal resection as a treatment for high-grade dysplasia or intramucosal adenocarcinoma arising from Barrett’s epithelium: a viable alternative to esophagectomy. Gastrointest Endosc 63:AB126CrossRefGoogle Scholar
  47. 47.
    Ell C, May A, Pech O et al (2007) Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer). Gastrointest Endosc 65:3–10PubMedCrossRefGoogle Scholar
  48. 48.
    Seewald S, Ang TL, Omar S (2006) Endoscopic mucosal resection of early esophageal squamous cell cancer using the Duette mucosectomy kit. Endoscopy 38:1029–1031PubMedCrossRefGoogle Scholar
  49. 49.
    Jaquet Y, Pilloud R, Grosjean P, Radu A, Monnier P (2007) Extended endoscopic mucosal resection in the esophagus and hypopharynx: a new rigid device. Eur Arch Otorhinolaryngol 264:57–62PubMedCrossRefGoogle Scholar
  50. 50.
    Gotoda T, Yamamoto H, Soetikno RM (2006) Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 41:929–942PubMedCrossRefGoogle Scholar
  51. 51.
    Rosch T (2006) Endoscopic submucosal dissection (ESD) section: an overview of articles in this issue. Endoscopy 38:978–979CrossRefGoogle Scholar
  52. 52.
    Imagawa A, Okada H, Kawahara Y et al (2006) Endoscopic submucosal dissection for early gastric cancer: results and degrees of technical difficulty as well as success. Endoscopy 38:987–990PubMedCrossRefGoogle Scholar
  53. 53.
    Oka S, Tanaka S, Kaneko I et al (2006) Endoscopic submucosal dissection for residual/local recurrence of early gastric cancer after endoscopic mucosal resection. Endoscopy 38:996–1000PubMedCrossRefGoogle Scholar
  54. 54.
    Lee IL, Lin PY, Tung SY et al (2006) Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy 38:1024–1028PubMedCrossRefGoogle Scholar
  55. 55.
    Neuhaus H, Costamagna G, Deviere J et al (2006) Endoscopic submucosal dissection (ESD) of early neoplastic gastric lesions using a new double-channel endoscope (the “R-scope”). Endoscopy 38:1016–1023PubMedCrossRefGoogle Scholar
  56. 56.
    Yonezawa J, Kaise M, Sumiyama K et al (2006) A novel double-channel therapeutic endoscope (“R-scope”) facilitates endoscopic submucosal dissection of superficial gastric neoplasms. Endoscopy 38:1011–1015PubMedCrossRefGoogle Scholar
  57. 57.
    McGee MF, Rosen MJ, Marks J et al (2006) A Primer on natural orifice transluminal endoscopic surgery: building a new paradigm. Surg Innovation 13:86–93CrossRefGoogle Scholar
  58. 58.
    Hochberger J, Lamade W (2005) Transgastric surgery in the abdomen: the dawn of a new era? Gastrointest Endosc 62:293–296PubMedCrossRefGoogle Scholar
  59. 59.
    Rattner D, Kalloo A (2006) ASGE/SAGES working group on natural orifice translumenal endoscopic surgery. Surg Endosc 20:329–333PubMedCrossRefGoogle Scholar
  60. 60.
    Hazey JW, Dunkin BJ, Melvin WS (2007) Changing attitudes toward endolumenal therapy. Surg Endosc 21(3):445–448Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Division of General SurgeryThe Ohio State UniversityColumbusUSA
  2. 2.Department of Surgery Division of Gastrointestinal SurgeryUniversity of CaliforniaOrangeUSA

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