Commentary

Endoscopists with enough experience would likely have encountered the horrifying situation of bleeding esophageal varices where the entire endoscopic image was covered by blood. The lack of clear view prevented visualization of the spurting varix and endoscopic variceal ligation would not be possible without a sufficient view of the bleeder. In this issue of Endoscopy, Sekiguchi et al. describe a novel method of gel immersion endoscopy that could improve the endoscopic view for timely variceal rubber band ligation [1]. The unique characteristics of gel act as an ideal medium for visualization of the bleeding from columns of varices. The accurate localization of the variceal bleeding point will certainly improve the success of band ligation and avoid massive hemorrhage leading to liver failure. With the development of specially designed gel for this purpose, it is expected that the gel immersion technique could be applied in more difficult scenarios during luminal therapeutic endoscopy [2] [3].

Publication History

Article published online:
27 July 2022

• References

• 1 Sekiguchi H, Yano T, Tokoro S. et al. Low-pressure endoscopy using the gel immersion method facilitates endoscopic variceal ligation of ruptured esophageal varices. Endoscopy 2021; DOI: 10.1055/a-1559-2120.
• 2 Yano T, Ohata A, Hiraki Y. et al. Development of a gel dedicated to gel immersion endoscopy. Endosc Int Open 2021; 9: E918-E924
• 3 Yano T, Takezawa T, Hashimoto K. et al. Gel immersion endoscopy: Innovation in securing the visual field – Clinical experience with 265 consecutive procedures. Endosc Int Open 2021; 9: E1123-E1127