The ever-growing scope of diagnostic and therapeutic colonoscopy
The introduction of fiber-optics in gastroenterology has revolutionized the field by introducing new avenues through which different gastroenterological diseases can be diagnosed and managed. Gastroenterologists are now able to visualize the disease process, able to obtain tissue samples and remove lesions on an outpatient basis that previously required major surgeries.
Colonoscopy has undergone numerous innovations and advances since its first introduction as a simple rigid sigmoidoscope using reflective lamp in 1884. In addition to flexible scopes with a light source, therapeutic channel, and use of water/air, some of the newer improvements include the addition of distal attachments (such as endocap, endocuff vision, etc.), virtual chromoendoscopy (such as linked color imaging, narrow band imaging, etc.), and balloon-assisted devices (G-EYE). Further, adjunct tools have aided the diagnostic and therapeutic capabilities such as snare, forceps, sutures, clips, nets, etc.
Colonoscopy is a powerful tool for both screening and therapeutics. Screening colonoscopies are now considered the gold standard for prevention of colorectal cancers. The recent introduction of artificial intelligence and computer aided detection in colonoscopy has tremendous potential in clinical applications with major reductions in interval cancer by optimizing precursor lesions recognition and subsequent removal.
In the therapeutic domain, colonoscopy is useful in controlling gastrointestinal bleeding, dilation/relieving obstruction of benign and malignant etiologies, relieving pseudo-obstructions and volvulus, and removal of large lesions using techniques such as endoscopic mucosal resection, endoscopic submucosal dissection, and full thickness resection.
The modern era is extremely exciting with newer innovations and techniques introduced at a rapid pace for all endoscopic procedures in the field of gastroenterology. There is no doubt that the field of gastroenterology is the most sought after by trainees in United States.
Acknowledgments
Funding: None.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, Translational Gastroenterology and Hepatology for the series “Colonoscopy: Updates and Prospects”. The article did not undergo external peer review.
Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-24-4/coif). The series “Colonoscopy: Updates and Prospects” was commissioned by the editorial office without any funding or sponsorship. M.A. served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Translational Gastroenterology and Hepatology from September 2022 to August 2024. V.T.C. served as the unpaid Guest Editor of the series. The authors have no other conflicts of interest to declare.
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Cite this article as: Aziz M, Chandrasekar VT. The ever-growing scope of diagnostic and therapeutic colonoscopy. Transl Gastroenterol Hepatol 2024;9:32.
