In 2016 the first edition of the SAGES Manual Operating through the Endoscope was published. At the time, this represented a review of cutting-edge new technologies that were being introduced within the field of flexible endoscopy. Largely based on applications and data up to 2013, this served as a unique resource for clinicians and researchers to learn about this expanding field.
Since then, there has been a significant expansion of new technologies and procedures within this discipline that have meaningfully changed this entire sub-specialty. In addition, large numbers of high-quality data have emerged that support more heartily the safety and efficacy of these techniques. Major international societies now routinely include hands-on training and scientific content of this field in meetings and educational efforts, and many trainees and practitioners are looking for resources to improve their knowledge and technical skills sets. For these reasons, an update on this rapidly advancing field seems appropriate at this time, given the enormous amount of new content available.
Endoscopic surgical procedures allow for less invasive access for performing increasingly complex procedures. This results in maximal benefit for patients with fewer complications, faster recovery, and less pain. Endoscopy allows access to the gastrointestinal tract without transgressing the abdominal or chest walls, by means of a truly less invasive route. These technologies and skills are being sought out by practitioners and asked for by patients.
The proposed textbook is designed to present a comprehensive and state-of the-art approach to the diverse applications of surgical techniques and procedures through the endoscopic platform. Written by experts and emerging specialists in that field, each of these sections will address patient selection, pre-operative considerations, technical conduct of the most common operations, and avoiding complications. A review of the existing literature addressing the particular topic will follow in each section. Extensive endoscopic images and illustrations will make this an interactive text. In addition to updates on most topics in the previous manual, this edition will include exciting new fields of advanced imaging, artificial intelligence and augmented imaging, applications of robotics to endoscopy, and more robust exposure of endoscopic applications for treatment of obesity, a worldwide epidemic.
The subject of surgical endoscopy has changed meaningfully since publication of the first edition; now a substantial focus of major journals, scientific meetings, and online platforms. A timely update can capture this broad subject in an accessible manual focused on technologies and data supporting these interventions.
Author(s): Matthew Kroh, Salvatore Docimo Jr., Sofiane El Djouzi, Amber Shada, Kevin M. Reavis
Edition: 2
Publisher: Springer
Year: 2023
Language: English
Pages: 998
City: Cham
Preface
Acknowledgments
Contents
Chapter 1: The Interface Between Therapeutic Gastrointestinal Endoscopy and Endoscopic Gastrointestinal Surgery
References
Chapter 2: Endoscopic Tools: Instruments
Introduction
Endoscope
Standard Instruments
Forceps
Snare
Injection Catheter
Endoscopic Cutting Tools
Retrieval Devices
Endoscopic Wires
Balloon Catheters
Clips
Band Ligation
Energy Devices
Electrocautery and Thermocoagulation Probes
Radiofrequency Ablation Catheters
Argon Plasma Coagulation Catheters
ERCP Instruments
Sphincterotome
Endoscopic Balloons
Endoscopic Baskets
Biliary Stents
Cholangioscopy
References
Chapter 3: Operating Platforms for Surgical Endoscopy
Introduction
History of Surgical Endoscopy
Traditional Endoscope-Assisted Visualization Platforms
Direct Drive Endoscopic System (DDES)
Incisionless Operating Platform (IOP)
Endomina System
DiLumen C2 and the Endolumenal Interventional Platform (EIP)
LumenR Tissue Retractor System
Integrated Visual Function Platforms
EndoSamurai
ANUBIScope
Flex Robotic System
Robotic Platforms
ViaCath System
Master and Slave Translumenal Endoscopic Robot (MASTER) System
Endoluminal Surgical (ELS) System
Additional Gastrointestinal Platforms
Bronchoscopy Platforms
Conclusion
References
Chapter 4: Endolumenal Electrosurgical Energy
Overview of Endolumenal Electrosurgery
Endosurgical Units and Common Endolumenal Devices
Risk Associated with Endolumenal Electrosurgical Devices
Future Directions
References
Chapter 5: Endoscopic Training—Surgeon and GI Paradigms
Scope of Practice for GI Endoscopists vs General Surgeons
ACGME/ABS Requirements for Surgical Trainees
Advanced Surgical Endoscopy Training
ASGE Requirements for Gastroenterology Fellows
Training Adjuncts for Fellows and Residents
The Effect of COVID-19 on Endoscopy Training
Community Practice Patterns and the Need for General Surgeon Endoscopists
References
Chapter 6: Advanced Training and Certifications in Endoscopy
Introduction
Training in Endoscopy
Defining Competence
Ablative Therapies
Endoscopic Bariatric and Metabolic Therapies (EBMTs)
“Third space” Endoscopy
ESD
POEM
Future Directions
Conclusion
References
Chapter 7: Upper Gastrointestinal Tract Bleeding
Introduction
Clinical Presentation
Initial Assessment
Nasogastric Tubes
Resuscitation and Transfusion
Risk Stratification
Timing of Endoscopic Intervention
Endoscopic Management of UGIB
Management of Nonvariceal UGIB (NVUGIB): The Arsenal
Injection Therapy
Mechanical Therapy
Thermal Therapy
Topical Therapy
The Right Intervention for the Right Pathology
Peptic Ulcer Disease (PUD)
Mallory–Weiss Tears (MWT)
Dieulafoy’s Lesion (DL)
Post-Surgical Acute Bleeding (PSAB)
Tumor Bleeding
Variceal UGIB (VUGIB)
Esophageal Varices (E.V.)
Gastric Varices (G.V.)
Conclusion
References
Chapter 8: Stricture Management: Interventional Options
Esophageal Anastomotic Strictures
Definition
Pathophysiology
Incidence and Risk Factors
Symptoms
Treatment
Dilators
Rigid Dilators
Balloon Dilators
Novel Transparent Dilators
Complications and Limitations of Dilators
Other Endoscopic Procedures
Stents
Metal Stents
Non-Metal Stents
Biodegradable Stents
Corticosteroid (Triamcinolone acetonide) Injection
Mitomycin C
Electrosurgical Needle Knife
Medical Management
Gastric Anastomotic Strictures
Definition
Pathophysiology
Incidence and Risk Factors
Treatment
Balloon Dilators
Other Endoscopic Procedures
Endolumenal Stents
Savary-Gilliard Dilators
Colorectal Anastomotic Strictures
Definition
Pathophysiology
Incidence and Risk Factors
Treatment
Balloon Dilators
Other Endoscopic Procedures
Rigid Dilators
Stents
Electrosurgical Coagulation
Endoscopic Transanal Resection of Strictures (ETAR)
References
Chapter 9: Upper Gastrointestinal Tract Leaks
Introduction
Early Diagnosis of GI Leaks
Management of Gastrointestinal Leaks in Esophagogastric Surgery
Endoscopic Stent and Suturing Management of Anastomotic Leakage after Esophagogastric Surgery
Endoscopic Suturing of Esophageal Leaks
Endoscopic Vacuum-Assisted Closure in Esophageal Anastomotic Leaks
Endoscopic Internal Drainage in Esophageal Anastomotic Leaks
Endoscopic Stent and Suturing Management of Gastrointestinal Leak After Gastric Bypass and Sleeve Gastrectomy
Early Gastrointestinal Leak After Gastric Bypass
Delayed Leak with Abscess
Early Gastrointestinal Leak after Sleeve Gastrectomy (LSG)
Endoscopic Clips and Suturing in Gastrotomy Closure
Endoscopic Internal Drainage and Endoscopic Vacuum Therapy After Sleeve Leak
Summary
References
Chapter 10: Endoscopic Treatment of Gastrointestinal Leaks
Introduction
Classification
Diagnosis
Endoscopic Treatment of Fistulae
Balloon Dilation
Stricturotomy
Endoclips
Self-Expanding Luminal Stent
Endoscopic Internal Drainage
Endoscopic Suture
Endoscopic Vacuum Therapy (EVT)
Tissue Sealant
Conclusion
References
Chapter 11: Lower Gastrointestinal Tract Bleeding
Introduction
Etiology
Initial Assessment and Management
Diagnostic and Treatment Options
Esophagogastroduodenoscopy
Colonoscopy
Computed Tomography Angiography
Therapeutic Mesenteric Angiography
Radionuclide Imaging
Surgery
Conclusion
References
Chapter 12: Endoscopic Stenting for Malignant Colorectal Obstruction
Background
Indication for Stenting (Table 12.1)
Bridge to Surgery
Palliative
Contraindications to Stenting
Types of Stents
Covered Versus Uncovered Stents
Placement of the Stent
Post-Stenting Follow-up
Complications after Stent Placement
Conclusion
References
Chapter 13: Interventional Procedures for Inflammatory Bowel Disease
Introduction
Endoscopic Management of Strictures
Endoscopic Balloon Dilation
Stricturotomy
Stent Placement
Intralesional Injection
Dysplasia Diagnosis and Management
Diagnosing IBD-Associated Dysplasia
Endoscopic Management of IBD-Associated Dysplasia
Other Therapeutic Endoscopic Procedures
Management of IBD Post-Operative Complications
Fistulas
Conclusion
References
Chapter 14: Enteral Access: Percutaneous Endoscopic Gastrostomy, Gastrostomy-Jejunostomy, and Jejunostomy
Introduction
Patient Selection
Gastric Feeding and Decompression
Jejunal Feeding
Special Considerations
Absolute Contraindications
Preoperative Considerations
Antibiotic Prophylaxis
Sedation
Anticoagulation and Antiplatelet
Consent
Techniques
Percutaneous Endoscopic Gastrostomy
Push and Introducer Techniques
Safe Tract Technique
Percutaneous Endoscopic Gastrjejunostomy
Percutaneous Endoscopic Jejunostomy
Laparoscopic Jejunostomy
Complications
Injury to Internal Organs
Fistula
Volvulus
Metastasis at PEG Site
Aspiration and Pneumonia
Necrotizing Fasciitis
Buried Bumper Syndrome
Peristomal Infection
Gastrointestinal Bleeding and Ulceration
Leakage
Dislodgement and Inadvertent Removal
Gastrointestinal Obstruction
Clogged PEG Tube
Pneumoperitoneum
Removal and Replacement of PEG
Conclusion
References
Chapter 15: Barrett’s Esophagus Surveillance: WATS, Real-Time Endoscopic Microscopy
Introduction
Wide-Area Transepithelial Sampling
Technology Overview
Clinical Evidence
Endoscopic Microscopy
Confocal Laser Endomicroscopy
Optical Coherence Tomography
Conclusions
References
Chapter 16: Barrett’s Esophagus Treatment: Radiofrequency and Other Ablation Modalities
Introduction
Radiofrequency Ablation
Introduction
Indications
Technique
Complications
Outcomes
Special Considerations
Conclusion
Chemical Photodynamic Therapy
Cryotherapy
Conclusion
References
Chapter 17: Endoluminal Gastroesophageal Reflux Disease Therapies
Introduction
Diagnosis and Management
Specific Endoluminal Therapies
Esophyx and Transoral Incisionless Fundoplication
Stretta® Radiofrequency Treatment of the Gastroesophageal Junction
Introduction
Mechanism of Action
Patient Selection
Stretta® Technique
Complications and Safety
Clinical Results
The Future of Endolumenal GERD Therapies
References
Chapter 18: Endomucosal Resection of the Upper GI Tract
Esophagus
Stomach
Duodenum
Patient Selection and Pre-operative Considerations
Technique
Injection-Assisted EMR
Cap-Assisted EMR
Ligation-Assisted EMR
Underwater EMR
Avoiding Complications
Bleeding
Stricture
Perforation
Complete Barrett’s Eradication Versus Targeted Resection
Conclusions
References
Chapter 19: Endoscopic Mucosal Resection: Colon and Rectum
Introduction
Why Should These Lesions Be Managed Primarily by Endoscopic Mucosal Resection and Not Surgical Colectomy?
Preparation for Endoscopic Mucosal Resection
What Are the Main Aims of Endoscopic Mucosal Resection of Benign Colorectal Neoplasia?
What to Do When These Lesions Are Discovered During Routine Colonoscopy?
Endoscopic Prerequisites for Performing Endoscopic Mucosal Resection
Carbon Dioxide Insufflation
Microprocessor-Controlled Electrosurgical Generators
Submucosal Injectate
Snares
Lesion Assessment
Overview and Focal Lesion Assessment
Risk Stratification of Covert Submucosal Invasive Cancer
Endoscopic Mucosal Resection Technique
Lesion Access and Positioning
Submucosal Injection Technique
Resection Technique
Complications and Optimizing Outcomes
Intraprocedural Bleeding
Delayed Bleeding
Deep Mural Injury and Perforation
Adenoma Recurrence
Thermal Ablation of the Post-EMR Margin Technique
Special Locations and Salvaging Techniques
Anorectal Junction Lesions
Ileocecal Valve Lesions
Circumferential Lesions
Non-lifting Lesions
Surveillance and Post-EMR Scar Assessment
Post-procedural Care
Diet
Pain
Cold Endoscopic Mucosal Resection
Cold Endoscopic Mucosal Resection Technique
Summary
References
Chapter 20: Endoscopic Submucosal Dissection: Upper Gastrointestinal Tract
Introduction
Comparison to Traditional Endoscopic Mucosal Resection
ESD Indications
Gastric ESD Indications
Esophageal ESD Indications
Preoperative Assessment
ESD Equipment
Distal Attachments
Lifting Solutions
ESD Knives
Coagulation Devices
Esophageal ESD Technique
Marking
Esophageal ESD Techniques
Clip Line Traction
Tunnel ESD
C-Shaped Incision: IT Tunneling Technique
Gastric ESD Technique
Marking
Circumferential Incision
Submucosal Dissection
Retraction Technology to Assist Esophageal and Gastric ESD
Clip Line Traction
Water Pocket
Tunnel ESD
S-O Clip
Traction Wire
Adverse Events
Bleeding
Perforations
Stricture
Conclusion
References
Chapter 21: Endoscopic Submucosal Dissection in Colon and Rectum
Introduction
Background
Indications
Periprocedural Management
Injectate Types and Injection Techniques
Materials and Devices
Endoscopic Mucosal Resection
Endoscopic Submucosal Dissection
Complications of Advanced Polypectomy
Updates in ESD and Future Directions
Learning Curve
Conclusion
References
Chapter 22: Peroral Endoscopic Myotomy (POEM)
Indications
Achalasia
Emerging Indications
History/Background
Patient Selection
Symptom Assessment Questionnaires
Physiologic Tests
High-Resolution Manometry
Timed Barium Esophagram (TBE)
Esophagogastroduodenoscopy (EGD)
EndoFLIP
Contraindications
Patient Factors
Technical/Training
Pre-operative Care
Patient Instructions
Anesthetic Considerations
Room Set-Up and Equipment
Operative Technique [Fig. 22.4]
Diagnostic Endoscopy
Mucosal Lift and Mucosotomy
Creation of the Submucosal Tunnel
Anterior Myotomy of the Circular Muscle Layer
Closure of Mucosotomy
Troubleshooting
Retained Debris
Avoiding Complications
Implications of COVID-19 Pandemic
Aspiration
Capnothorax
Bleeding
Full-Thickness Perforation
Postoperative Care
Follow-Up
Review of Existing Literature
Efficacy
Rates of GERD
Conclusion
References
Chapter 23: Intramural Surgery Per Oral Endoscopic Myotomy for Zenker’s Diverticulum (Z-POEM)
Intramural Surgery Per Oral Endoscopic Myotomy for Zenker’s Diverticulum (Z-POEM)
General Technical Principles
Flexible Endoscopic Septum Division
Submucosal Tunneling Technique: Z-POEM [Q]
Endoscopic Mucosal Incision and Muscle Interruption (MIMI)
Postoperative Care
Outcomes
Future Developments
References
Chapter 24: Intramural Surgery: Per Oral Pyloromyotomy
Development of the Per Oral Pyloromyotomy
The Nature of the Problem: Gastroparesis
The Evidence
Pre-operative Work Up
The Set Up
Step by Step Per Oral Pyloromyotomy
Post-operative Management
Future
References
Chapter 25: Per-Oral Endoscopic Tunneling for Restoration of the Esophagus (POETRE)
Complete Esophageal Obstruction
Endoscopic Treatment Options
Per-Oral Endoscopic Tunneling for Restoration of the Esophagus (POETRE)
History
Pre-operative Considerations
Anesthetic Considerations
Patient Positioning and Pre-operative Medications
Technique
Step 1: Endoscopic Assessment
Step 2: Fluoroscopic Measurements
Step 3: Saline Lift and Mucosotomy
Step 4: Submucosal Tunnel Formation
Step 5: Navigation Across the Obstructed Segment
Step 6: Passing of the Guidewire and Stent Placement
Post-procedure Care
Results
Complications
Bleeding
Perforation
Conclusion
References
Chapter 26: Operating Through the Endoscope: Endoscopic Full-Thickness Resection
Background
Current Techniques Used for EFTR
Exposed EFTR
Tunneled Exposed EFTR
Non-tunneled Exposed EFTR
Non-exposed EFTR
Indications for EFTR
Contraindications of EFTR
Preoperative Considerations
Post-operative Care and Follow-Up
Clinical Outcomes of ETFR
Efficacy of EFTR in Upper Gastrointestinal Tract Lesions
Esophageal Tumors
Gastric Tumors
Duodenal Tumors
Efficacy of EFTR in Lower Gastrointestinal Tract Lesions
Colonic Tumors
Limitations and Challenges
Conclusion and Future Perspectives
References
Chapter 27: Submucosal Tunneling Endoscopic Resection of GI Submucosal Tumors
Background
Description
Efficacy
Conclusion
References
Chapter 28: Thoracic Applications Per Oral Plication of the Esophagus (POPE)
Introduction
Megaesophagus
Achalasia
End-Stage Treatment
Clinical Approach
Neoesophagus
Delayed Gastric Emptying
Clinical Approach
Operative Description
Device
Procedure
Technical Considerations
Durability
Conclusion
References
Chapter 29: Thoracic Applications: Endoscopic Approaches to Benign Esophagorespiratory Fistula Closure
Introduction
Evaluation of Fistula
Therapeutic Approaches
Stenting
Mechanical Closure Techniques
Occlusion of Tract
Mucosal Disruption
Endoscopic Mucosal Resection
Clinical Success
Conclusion
References
Chapter 30: Endoscopic Ultrasound (EUS) Guided Biliary Drainage
History and Background
Training Issues
Indications
Definitions
EUS-BD with Emphasis on EUS-GBD
Procedure Outcomes
Description of Techniques
Common Bile Duct (CBD) Drainage
EUS Gallbladder Drainage (EUS-GBD)
Hepaticogastrostomy
Rendez-vous Technique
Conclusions
References
Chapter 31: EUS-Directed Transgastric ERCP (EDGE Procedure) for Management of Choledocholithiasis in Post-Gastric Bypass Anatomy
Introduction
Technical Innovation
Techniques and Pitfalls
Outcomes
Conclusions
References
Chapter 32: Advanced EUS: Future Applications
Introduction
Diagnostic EUS
Therapeutic EUS
References
Chapter 33: Cholangioscopy
Cholangioscopy
Transhepatic Cholangioscopy
Peroral Cholangioscopy
Electrohydraulic Lithotripsy
Conclusion
References
Chapter 34: Role of Endoscopic Bariatric Therapies in a Comprehensive Multidisciplinary Metabolic and Bariatric Program
Introduction
Pre-operative Endoscopy
Intra-Operative Endoscopy
Endoscopy to Manage Post-operative Complications
Endoscopy and Dilation for Stricture After RYGB and SG
Endoscopy for Upper GI Bleeding After RYGB
Endoscopy for Treatment of Leaks
Primary Endoscopic Therapy for Obesity
Space Occupying Devices
Endoscopic Suturing/Stapling Devices
Aspiration Therapy
Endoscopic Small Intestine Bypass Technology
Conclusions
References
Chapter 35: Endoscopic Anatomy of the Bariatric Patient
Introduction
Pre-operative Endoscopic Evaluation
Postoperative Endoscopic Evaluation
Sleeve Gastrectomy
Normal Findings
Abnormal Findings
Chronic Sleeve Fistula
Roux-en Y Gastric Bypass
Normal Findings
Abnormal Findings
A Laparoscopic Adjustable Gastric Band (LAGB)
Normal Findings
Abnormal Findings
Band Erosion
Biliopancreatic Diversion with Duodenal Switch (Single Vs. Two Anastomosis)
Normal Findings
Abnormal Findings
Vertical Banded Gastroplasty
Normal Findings
Abnormal Findings
Conclusions
References
Chapter 36: Intragastric Balloon Therapy
Placement and Removal
Conclusion
References
Chapter 37: Endoscopic Liners (Duodenojejunal Bypass Liner, Gastroduodenojejunal Bypass Sleeve)
Introduction
Implantation/Retrieval
Pre-Implantation/Post-Implantation Considerations
Indications/Contraindications
EndoBarrier Is Contraindicated in the Following Patients
Clinical Outcomes/Efficacy
Mechanisms of Action
Complications
Summary
References
Chapter 38: Endoscopic Sleeve Gastroplasty
Introduction
Indication
Contraindications
How ESG Induces Weight Loss
Setup/Tools Requirement (Table 38.2)
Device Overview
Technique
Alternate Suturing Patterns
Reinforcement
ESG in Pediatric Age Group
Perioperative Protocol for Patients Undergoing ESG
Results
Impact of ESG on Weight Loss
Complications and Management
Conversion to Laparoscopic Sleeve Gastrectomy (LSG) and Redo ESG
ESG as a Revisional Procedure
How Does ESG Compare to Laparoscopic Sleeve Gastrectomy?
Barriers and Concerns
Pearls in Performing ESG
ESG Technical Principles
Improve Visualization and Orientation
Conclusion
References
Chapter 39: New Technologies to Treat Obesity and Related Comorbidities
Introduction
Duodenal Mucosal Resurfacing (DMR)
Magnetic Anastomosis System (GI Windows Inc.)
Intragastric Satiety-Inducing Device (ISD)
Sleeveballoon
Gastric Mucosal Devitalization (GMD)
Conclusion
References
Chapter 40: Endoscopic Bariatric Revisional Procedures
Introduction
Endoscopic Procedures and Devices
Transoral Outlet Reduction (TORe)
Restorative Obesity Surgery Endoscopic (ROSE)
Argon Plasma Coagulation of the Gastrojejunal Anastomosis
Endoscopic Sclerotherapy
Future Directions
Summary
References
Chapter 41: ERCP and the Bariatric Patient
Introduction
RYGB (Fig. 41.1)
OAGB (Fig. 41.2)
BPD-DS (Fig. 41.3)
SADI-S or OADS (Fig. 41.4)
Management
Enteroscopy-Assisted ERCP
Transgastric ERCP
Surgical Transgastric ERCP
Endoscopic Ultrasound-Directed Transgastric ERCP (EDGE)
Surgical Transenteric ERCP
Evidence-Based Algorithm for Choledocholithiasis Post-RYGB
Conclusion
References
Chapter 42: Hybrid Laparoscopic and Endoscopic Techniques: Upper Gastrointestinal Tract
Introduction
Gastric Lesions
Gastrointestinal Stromal Tumor (GIST)
Gastric Cancer
Gastric Hybrid Procedures
Patient, Surgeon, and Endoscopist Positioning
Classic LECS (Laparoscopic and Endoscopic Cooperative Surgery)
Inverted LECS
NEWS (Non-exposed Endoscopic Wall-Inversion Surgery)
CLEAN-NET (Combined Laparoscopic Endoscopic Approach to Neoplasia with a Non-exposure Technique)
Closed LECS
Discussion
Gastric Lesions
Duodenal Lesions
Future
Conclusion
References
Chapter 43: Hybrid Laparoscopic and Endoscopic Techniques: Colon and Rectum
Laparoscopic-Assisted Endoscopic Polypectomy (LAEP)
Endoscopic-Assisted Wedge Resection
Laparoscopic-Assisted Transluminal Resection
Endoscopic-Assisted Laparoscopic Segmental Resection
Preoperative Preparation
Operative Setup
Operative Procedure
Colonoscopy (Fig. 43.2)
Port Placement
Colon Mobilization and Manipulation
Polypectomy (Figs. 43.3, and 43.4)
Full-Thickness CELS
Colonoscopic-Assisted Laparoscopic Partial Cecectomy (Fig. 43.6)
Intraoperative Frozen Pathology
Complications
Postoperative Care
Follow-Up
Contraindications
Learning Curve
Conclusion
References
Chapter 44: Natural Orifice Translumenal Endoscopic Surgery (NOTES™)
Introduction
History
Current Status of Procedures
Transesophageal
Transgastric
Transvaginal
Transanal
Ongoing Challenges
Future Directions
References
Chapter 45: Artificial Intelligence in Endoscopy
Introduction
Definitions and Terminology
Machine Learning (ML)
Deep Learning (DL)
Current Applications of Artificial Intelligence in Endoscopy
Evaluation of Barrett’s Esophagus
Esophageal Squamous Cell Carcinoma
Detection of Helicobacter pylori (H. pylori) infection
Colonic Polyp Detection
Detection of Inflammatory Conditions
AI—Limitations and Challenges
Conclusion
References
Chapter 46: Advanced Imaging Through The Endoscope
High-Definition Endoscopy
Chromoendoscopy
Virtual Chromoendoscopy
Confocal Laser Endomicroscopy
Conclusion
References
Chapter 47: Robotics in Endoscopy/Tele-Endoscopy
History
Current Robotic Endoscopy Systems
Invendoscope E200™ System (Invendo Medical, GmBH Germany)
Flex® Robotic System (Medrobotics Corp., Raynham MA)
Monarch® Robotic Platform
Ion™ Robotic Platform
Products in Development
EndoMaster EASE (Endoluminal Access Surgical Efficacy) System
ISIS-Scope/STRAS System
Summary and Future Directions
References
Chapter 48: Future Horizons in Flexible Endoscopy
Introduction
Flexible Robotic Endoscopy
AI and Deep Learning
Robotic Endoscopic Capsules
Therapeutic Endoscopic Ultrasound
Augmented Imaging and Navigation
Conclusion: New Role for NOTES?
References
Index
