Advances in diagnostic endoscopy

Detection of potentially subtle abnormalities during diagnostic endoscopy is limited by the quality of the equipment, the skill of the endoscopist, and patient comfort. Rapid advances are occurring in endoscopic technology. Miniature probes offering confocal endomicroscopy, fluorescence, elastic scattering and Raman spectroscopy can all now be used with standard endoscopes. Novel endoscopes such as ‘SpyGlass’ and the ‘Third Eye Retroscope’ have been developed to visualize new regions of the gastrointestinal tract, while the development of thinner more flexible endoscopes, scope-guide systems, colon and pH capsules, and virtual colonoscopy aim to improve patient comfort and satisfaction. While impressive, many of these techniques are still confined to the research arena. The most significant recent advances in routine diagnostic endoscopy are the introduction of high-resolution endoscopes and high-definition TV as well as the introduction of the National Bowel Cancer Screening programme to diagnose and treat colon cancer at a much earlier stage.