Creating the Future of (Endoluminal) GI Interventions

Abstract

Major innovation into how we pursue diagnosis and therapies for gastrointestinal (GI) diseases is urgently needed to seek better, less invasive, and less costly innovations in diagnostic and therapeutic interventions in the GI tract. Learning from prior paradigm shifts in cardiac and vascular we present here several initial steps we have undertaken to follow the endoluminal path, using advanced imaging methods, including endoscopy, and data management with avoidance of entry into a body cavity when possible. We will review the benefit and ease of incorporating routine fluoroscopy with endoscopy to improve safety and efficiency. We describe the development of “hybrid” procedure rooms for GI interventions and rationale for their use. We also emphasize the importance of collaborating with interventional radiologists, software engineers, and data specialists. We predict major improvement in outcomes in both diagnosis and treatment will follow.

Keywords

endoluminal surgery - hybrid operating room - fluoroscopy - health care costs - GI diseases

Publication History

Article published online:
17 July 2023

• References

• 1 Araghi M, Soerjomataram I, Jenkins M. et al. Global trends in colorectal cancer mortality: projections to the year 2035. Int J Cancer 2019; 144 (12) 2992-3000
• 2 Accessed June 18, 2023 at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet
• 3 Accessed June 18, 2023 at: https://www.census.gov/newsroom/press-releases/2020/65-older-population-grows.html
• 4 Swerdlow NJ, Wu WW, Schermerhorn ML. Open and endovascular management of aortic aneurysms. Circ Res 2019; 124 (04) 647-661
• 5 Law R, Das A, Gregory D. et al. Endoscopic resection is cost-effective compared with laparoscopic resection in the management of complex colon polyps: an economic analysis. Gastrointest Endosc 2016; 83 (06) 1248-1257
• 6 Jayaram A, Barr N, Plummer R, Yao M, Chen L, Yoo J. Combined endo-laparoscopic surgery (CELS) for benign colon polyps: a single institution cost analysis. Surg Endosc 2019; 33 (10) 3238-3242
• 7 Cohan JN, Donahue C, Pantel HJ. et al. Endoscopic step up: a colon-sparing alternative to colectomy to improve outcomes and reduce costs for patients with advanced neoplastic polyps. Dis Colon Rectum 2020; 63 (06) 842-849
• 8 Matsuo K, Urakawa S, Symer M, Sedrakyan A, Pua B, Milsom J. Iterative evaluation of novel access techniques for small bowel obstruction: combining image guided, percutaneous, and endoscopic methods. BMJ Surg Interv Health Technol 2023; 5 (01) e000150
• 9 Ho SG, Marchinkow LO, Legiehn GM, Munk PL, Lee MJ. Radiological percutaneous gastrostomy. Clin Radiol 2001; 56 (11) 902-910
• 10 Partovi S, Li X, Moon E, Thompson D. Image guided percutaneous gastrostomy catheter placement: how we do it safely and efficiently. World J Gastroenterol 2020; 26 (04) 383-392