Gastrointestinal Surgery and Endoscopy Device Innovation

Frost & Sullivan has identified innovation themes in endoscopy, with significant advancements over the past 20 years in enhanced visualization and integration, optimal navigation and ease of access, accessory innovations, and easy maneuverability.

The field of gastrointestinal (GI) surgery has undergone revolutionary transformation over the past three decades, effectively moving toward a minimally invasive approach to address surgical pathology and minimize morbidities associated with traditional surgical approaches. The global push by health care systems to rein in costs and move to an outpatient-based surgical system has driven the use of minimally invasive endoscopes for both diagnostic and therapeutic purposes in several GI indications.

Endoscopes are complex medical devices that consist of a thin, long tube fitted with high-end cameras. They are directly inserted into a patient’s body through natural openings such as the mouth or anus, or through small incisions in body parts such as the knee or abdomen, to observe an internal organ or tissue in detail. They are also used to carry out additional tasks, such as imaging or taking tissue biopsies for further diagnosis, and to perform detailed surgical procedures, such as removal of tumors or polyps from digestive tracts. The two primary endoscope types (rigid and flexible), when combined with support systems including video processors, converters, light sources, wireless display monitors, insufflators and electro-surgical generators; and accessories such as trocars, stitches, balloons, dilators, mouthpieces and biopsy valves, form a complete, fully functional endoscopy system. These systems are used for ear, nose and throat (ENT); arthroscopy; gynecology; neurology; urology; and pulmonary procedures.

In the GI space, endoscopes are useful for investigation and treatment of the esophagus, stomach, duodenum, small and large intestine/colon, pancreas, liver, bile duct, rectum and anus.

Frost & Sullivan has identified innovation themes in this field, with significant advancements over the past two decades in four key aspects.

  • Enhanced visualization and integration: High-definition visualization using optical filter technologies such as narrow band imaging and chromo-endoscopy, when used in combination with zoom magnification, improve diagnostic accuracy and allow detailed characterization of polyps, targeted biopsies and precisely guided therapeutic interventions.
  • Optimal navigation and ease of access: The advent of capsule endoscopy has enabled effective visualization of the small intestine, which is difficult to view using standard endoscopy. Innovations in minimally invasive robotic surgical systems and next-generation 3-D navigation systems enhance procedural effectiveness.
  • Accessory innovation: Innovations in trocars, knives and other accessories enable effective endoscopic mucosal resection, mucosal incisions, submucosal dissections and precision cutting for early removal of gastrointestinal cancer, and help patients avoid open GI surgeries.
  • Easy maneuverability: One of the latest additions to the laparoscopic field is hand-assisted laparoscopy, which allows better maneuverability of large organs and tumors. Almost all cancers that occur in the abdominal and pelvic region can be operated upon laparoscopically.

Frost & Sullivan has noticed several innovative companies in the domain:

Olympus (Tokyo, Japan)

The Olympus Visera 4K UHD surgical endoscopy system was introduced in 2015. The fully integrated system delivers four times the resolution of high definition (3840×2160 pixels) with light and wider color spectrum to better differentiate between tissues. This enables better visualization of anatomical patterns for better surgical precision. It comes with a 55-inch display of live, magnified anatomical features that provides real-time visual information to the entire surgical team.

Pentax Medical (Tokyo, Japan)

Pentax Medical launched its Optivista and Scopepilot endoscopy visualization and navigation technologies in 2016. The Optivista EPK-i7010 high-definition video processor features both digital and optical image enhancements to provide accurate endoscopic in vivo diagnosis through improved vessel and mucosal pattern characterization. The Scopepilot 3-D colon navigation system offers real-time navigation of the endoscope’s position in a patient’s bowel for effective insertion tracking and colonic loop management.

Avantis Medical Systems (San Jose, Calif.)

Avantis created its advanced Third Eye Panoramic system to provide physicians with up to a 330-degree view of the colon, as opposed to only a 140- to 170-degree view of a traditional, forward-facing colonoscope, so physicians can screen behind the folds and flexures of the colon. Frost & Sullivan found that this unique device allows physicians to continue to use the colonoscope system that they prefer, and is a low-cost solution for hospitals seeking to improve their detection rates.

TransEnterix (Morrisville, N.C.)

Robotic surgery systems have been lacking tactile or touch-based feedback from the surgical site, which often renders them less reliable than traditional surgical approaches. TransEnterix developed  a  portfolio  of  robotic surgery systems that includes Senhance,  a  multi-port surgical robot, and SurgiBot, a single port system. Both have an array of innovative features such as eye-sensing camera control and tactile feedback. Eye-sensing is a feature that lets the surgeon control the endoscopic camera with the movement of the eye. Using a special lens system, the surgeon is able to guide the camera to pan and move without touching. The other innovative feature imparts sensory feedback to the robotic arms and the surgical probes.  This ensures that the surgeon is aware of the force that the probes generate at the tissue level. Without this, the surgeon cannot determine how much pressure or force needs to be added at the surgical site, potentially putting the patient in danger.

The Road Ahead

Companies in the domain have long been focusing on enhancing visualization and navigation of their endoscopes. This is expected to continue over the next decade, though more attention also will be paid to innovations in endoscopic accessories to improve an endoscope’s use in tissue resection, polyp removal and high-precision biopsies, which would reduce the number of open surgeries and save money. 

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