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Special report: Endoscopy, doing more for less

by Lauren Dubinsky, Senior Reporter | March 18, 2014
Endoscopy International Day of Radiology 2012
From the March 2014 issue of HealthCare Business News magazine

Shaninian has big plans for this device outside of brain surgery. “I think this a significant breakthrough in all kinds of surgery because MARVEL will transcend the field of skull base and brain surgery and it will be valid in any kind of surgery,” he says.

Shaninian estimates that it will take nine to 12 months to get FDA 510(k) approved.

Another endoscopy update has been brought to market by Olympus. The company recently released what they claim to be the world’s only HD and 3-D endoscope called the ENDOEYE FLEX 3D Videoscope.

A surgeon who performs laparoscopic surgery with a traditional endoscope loses depth and has to train their minds to operate two-dimensionally. But this 3-D endoscope restores the natural vision that they would see in an open procedure.

After the surgeon places the endoscope into the trocars, they put on 3-D glasses and the organ or tumor is displayed in 3-D on the two monitors on each side of the patient.

“What this does is, and we have data to prove this, is makes their movements more precise, it reduces the number of errors and it improves or speeds up the learning curve for learning how to do laparoscopic surgery,” says Olympus’ Colvin.

Another unique feature is that the tip articulates, so surgeons are able to view desired organs from the angle they want. “They have better sight lines and they can peer around anatomical structures, like a large uterus or a tumor, and they can look at that structure from many different angles in 3-D, this provides more precise grasping, more precise dissection,” says Colvin.

Stryker has also recently created an articulating HD device called IDEAL EYES HD Articulating Laparoscope. With these new devices surgeons are able to see structures from angles they previously couldn’t, making surgery much more efficient.

Getting more minimal
Virginia Mason Hospital and Seattle Medical Center’s Ross says that the two minimally invasive procedures of most interest right now are endoscopic submucosal dissection, ESD, and peroral endoscopic myotomy, POEM.

“This is probably the biggest trend, the idea that we can actually work in the submucosal to dissect off early cancers and also to treat other diseases like Achalasia where we can actually tunnel through the wall of the esophagus and cut muscle fibers and traditionally that’s been done surgically,” says Dr. Ross.

ESD removes large lesions in the GI tract. It was developed in Japan in the mid-1990s. Prior to ESD, polypectomy was commonly used to remove the lesions. ESD is a breakthrough because unlike polypectomy, it leads to shorter hospital stays and recovery times.

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