Endoscopy has developed at breakneck speed since the 1960s. From its tentative baby steps as a diagnostic tool, to the full-on sprint of today’s rapidly evolving exceptional therapeutic methods and instruments. Having reached the 2020 milestone, it seems an ideal time to review some key advancements in this exciting field.
60s-70s
- 1965, flexible catheter (Rabinov and Simon, University of Chicago).
- 1966 first automatic insufflator (Kurt Semm).
- 1968 beginnings of ERCP (William McCune, George Washington University).
- 1969 side-viewing fiberoptic duodenoscope.
- 1970 first low-loss optical fiber (Corning) provides better lighting.
- 1970s Endoscopic Sclerotherapy (EST) begins to be widely used.
- Mid 1970s Camran Nezhat first to operate ‘off the monitor.’
80s-90s
- 1980 The first biliary stent was placed endoscopically (Nib Sohendra).
- 1982 solid-state computer chips introduced to video endoscopy.
- 1987 the United States Surgical Corporation designed a disposable trocar called the SurgiPort.
- Late 1980s endoscopic band ligation of esophageal varices introduced as an alternative to EST.
- 1989 William Chang (w. Stryker) used existing 3-chip technology for endoscopic video cameras.
- 1994 Self-expandable metal stents (SEMS) developed.
- Techniques such as prophylactic pancreatic stent placement were adopted to make ERCP safer in high-risk patients for post-ERCP pancreatitis.
The 21st century:
- 2005 NOTES first used.
- 2007 First launching of Spyglass, Boston Scientific, enabling the viewing of bile paths, etc.
- Single operator system for intraductal lithotripsy.
- Disposable scopes with a focus on ERCP examinations.
- Full-thickness resection with a capped endoscope
- Improvements in sampling techniques.
- Endoscopic suturing systems to allow, for instance, endoscopic sleeve gastroplasty.
The future is bright….
Naturally, the field is not standing still. We’ve only scratched the surface of the potential of many of the innovations mentioned above and bright and creative minds are continually inventing new, and enhancing existing, equipment. In addition, with the potential to revolutionize diagnostics, the true impact of artificial intelligence (AI) in endoscopy is still on the horizon. This is the theme of one of our future blogs. Other topical themes will follow.
In these future articles we’d like to ask the question: after six decades of frenetic development, are there elements of this ever-evolving automation that need to be reassessed? Naturally, it is important that new devices continue to be developed but, for instance, are their areas where the fascination for technology overshadows practical lower-tech solutions?
Watch this spot!