Vol.1 No.1, November 30, 2023
Endoscopy is an examination method that uses an endoscope to observe the inside of the body. The history of endoscopy dates to Greek and Roman times, and even at that time, the inside of the body was observed using a speculum, and the record of the rectal examination of Hippocrates can be seen. Endoscopy started with a rigid endoscope, developed into a semi-rigid endoscope, and a flexible endoscope. Since then, the development of electronic endoscopes, various treatments using endoscopes, and recently capsule endoscopes have been developed, and the use of artificial intelligence has been in the spotlight. In the era of advanced endoscopy in 21st century, it would be meaningful to point out the history of endoscope development so far. Endoscopy began as a simple metal cylinder, but gradually evolved from rigid to flexible and with the constant improvement of light transmission systems and lenses into the high-definition and excellent diagnostic and therapeutic instruments that it is today.
Endoscopic submucosal dissection (ESD) is a technically challenging procedure with complex instrumentation and a high risk of complications, even for endoscopists with extensive experience in diagnostic endoscopy. To perform ESD, a systematic education and training program are essential. Among the various training methods available for novice ESD practitioners, EndoGEL ESD training appears to be the most practical approach. EndoGEL training starts with setting up an EndoGEL ESD kit on a Koken EGD simulator at the appropriate angle for the procedure. Prior to initiating the training, practicing instrument maneuvers in multiple directions (vertical, horizontal, and circular) is recommended. In the actual training, trainees can perform a series of steps on a simulated lesion, including initial puncture, circumferential cutting, submucosal dissection, and final dissection using the pin knife or ball knife techniques. EndoGEL ESD training is most effective when conducted through one-on-one personalized instruction. After approximately three training sessions to gain proficiency, it is advisable to proceed to live pig ESD training. I hope that EndoGEL ESD training becomes more widely practiced in the endoscopic community.
Gastrointestinal endoscopy has become a very important platform in the diagnosis and treatment of various gastrointestinal diseases, propelled by application of innovative technological advancements. This review paper explores the current landscape, limitations, and ongoing developments in gastrointestinal endoscopy devices. This comprehensive review emphasizes persistent challenges and unmet needs. The prioritized quest for higher resolution, improved image quality, enhanced maneuverability, and user-friendliness presents a roadmap for future innovations. The integration of artificial intelligence emerges as a groundbreaking advancement, promising safer and more accessible endoscopic procedures for patients and practitioners. As the field continues to evolve, collaboration between clinicians, engineers, and researchers will be pivotal in shaping a more effective and patient-centric future for gastrointestinal endoscopy.
Depending on the clinical presentation, cases in which the wall structure of the gastrointestinal tract is damaged can be broadly classified into perforation, leakage, and fistula. Perforation is an acute full-thickness rupture of the wall of the gastrointestinal tract and is often caused by endoscopic procedures. Leakage mainly occurs at the anastomosis after surgery and can be defined as a case where passages are created inside and outside the gastrointestinal tract due to full-thickness damage to the gastrointestinal wall structure. A fistula is defined as a connection between adjacent organs in the gastrointestinal tract and an abscess. In this article, we will learn about endoscopic treatment of gastrointestinal perforation, leakage, and fistula.
In the advancements of medical technology and endoscopic equipment, endoscopic ultrasonography (EUS) has emerged as a valuable tool, integrating endoscopy and ultrasound functions into a single instrument. EUS offers high-resolution ultrasound images, exceeding those obtained through conventional transabdominal ultrasonography. Furthermore, advanced techniques, such as contrast-enhanced EUS and elastography, have been widely adopted in EUS. Therefore, this paper aims to explore the practical utility of EUS in the evaluation of pancreatic diseases.
Background: The flexible endoscopy system is a key device for observing the gastrointestinal tract non-invasively in real-time. Traditional endoscopes pose challenges such as musculoskeletal risks due to their heavy weight, and a steep learning curve for doctors due to their complexity. While robotic endoscopes have emerged, a high-performance system for gastroenterology department remains undeveloped. This study explores the feasibility of developing a high-performance robotic flexible gastroscope to enhance stability and accuracy in endoscopic procedures.
Materials and Methods: In this study, a system was developed using a high-precision motor to control the precise movement of the endoscope's distal-end, and a high-precision 6 degree-of-freedom sensor was used to track the actual movement of distal-end. Experiments were conducted based on six motor control rotational velocities to test the angle accuracy of the robotic endoscope's distal-end.
Result: Mean error for all velocity was –1.11° and mean absolute error was 1.55°. These results demonstrate the feasibility of controlling the distal-end of a robotic flexible gastroscope utilizing the motor.
Conclusion: The study confirmed the potential of developing a robotic flexible endoscope by electrically controlling its distal-end using a motor. Robotic endoscopy can assist users in performing endoscopic operations more efficiently and may potentially reduce variations in examination results due to the practitioner's proficiency.
Background: In colorectal cancer (CRC) screening, artificial intelligence (AI)-based software was developed to predict the risk of adenomas to compensate for the inconvenience and low sensitivity of fecal occult blood tests. This study investigates the applicability of this program for predicting risk using health-screening questionnaire data collected in real clinical settings.
Materials and Methods: Using a questionnaire accessible through web/mobile applications, data were collected from 516 examinees from an institution. The risk of colorectal adenoma and high-risk adenomas was then predicted by applying the AI-based algorithm, and the accuracy of the predictions evaluated by comparison with colonoscopy and pathology results. Additionally, the satisfaction survey of the examinees with the use of the program was investigated.
Result: The subjects were 49.7% male, median age was 59 years, 35.2% had body mass index over 25, family history of CRC was 8.6%, smoking was 39.7%, and alcohol consumption was 53.2%. Pathological results showed that adenomas were diagnosed in 42.2%, high-risk adenomas in 6.3%, and cancer in 4 patients (0.8%). There was a significant difference in the risk score between the adenoma positive and negative groups (40.8 vs 35.8, P≤0.001), and the accuracy of predicting risk of adenoma was 60.3%. The satisfaction survey received a positive response score of 75% or more.
Conclusion: Using a questionnaire in the form of familiar applications has the potential to supplement current screening methods, and is expected to be used in the future for effective CRC prevention through continuous data learning.
In this paper, we propose a connection that replaces the conventional surgical knotting to improve the ease of procedure, to reduce surgical time, and to secure the connection of a magnetic anal sphincter. The magnetic anal sphincter is implanting device to prevent fecal incontinence of patients. The proposed connection has a kind of simple snap-fit made by 3D printing. This mechanism may help skilled surgeons reduce the time required to knot the magnetic sphincter device when he/she is implanting it on a patient. In addition, the 3D printed snap-fit connection allows even novices to perform the procedure easily and the connection is secure.
Tae-Se Kim, Jun Haeng LeeJ Innov Med Technol 2023;1: 5-9
Jeong Seop Moon, Seung Jung Yu, Sam Ryong JeeJ Innov Med Technol 2023;1: 1-4