Introduction

Advances in imaging

Advances in endoscope design

Advances in therapeutic endoscopy

Key references

Abstract

The requirement for efficient endoscopic visualization and instrumentation has increased over the past decade given the considerable burden that luminal disorders of the gastrointestinal tract exert on individuals and healthcare economies. The push for greater diagnostic yield has driven advances in optical physics and bioengineering, which are revolutionizing diagnostic and therapeutic endoscopy. This article highlights emerging technologies since our last review, focusing on advances in imaging and endoscope design, and how these are shaping the therapeutic approach to diseases of the human gastrointestinal tract. Their application to improving diagnostic ability and patient care, as well as their limitations, are discussed.

Introduction

High-definition (HD) digital technology has moved endoscopic imaging to a new dimension. Endoscopic innovations have arisen from the explosion of technical achievements through the interaction between physicians and engineers, and the incorporation of technology from other fields such as computing, artificial intelligence and physics. These endoscopic advances are important to meet the need that we are still missing upper gastrointestinal (GI) cancers and colonic polyps. A meta-analysis showed that 11.3% of upper GI cancers were missed during endoscopy up to 3 years before diagnosis.1 Hand in hand with these advancements in imaging, there is a continuing evolution of the ergonometric design of endoscopes, with dedicated accessories that allow increasing applications of therapeutic endoscopy. The endoscopic treatment of early cancers of the GI tract continues to advance at a pace and is being constantly driven by improved imaging.