Gastroenterology and Hepatology

Endoscopic Innovations in Gastroenterology and Surgery

High-definition and magnification endoscopes with electronic chromo endoscopy capability make it easier to visualize subtle lesions, such as small and flat polyps and patches of dysplastic gastrointestinal mucosa. They allow accurate characterization of polyps, which may in the future allow us to selectively resect only precancerous colonic polyps, while ignoring small benign hyperplastic polyps, which in turn will result in significant healthcare savings.  New digital choledochoscopes have vastly improved diagnostic and therapeutic capabilities within the bile and pancreatic duct. Confocal endomicroscopy now allows us to perform microscopic evaluation of living tissues, improving targeted biopsies in Barrett's esophagus and aiding in the evaluation of bile duct strictures and pancreatic cysts. Similarly, technological advances in endoscopic ultrasound, optical coherence tomography and spectroscopy hold great promise for improving diagnostic and therapeutic capabilities for gastrointestinal disease.