Advances in therapeutic endoscopy

The field of gastrointestinal endoscopy has progressed significantly in the last few decades. There has been a tremendous expansion leading not only to improved diagnosis but treatment of gastrointestinal disorders, especially early neoplasia. Many gastrointestinal disorders originally requiring surgical intervention are now being managed using less and minimally invasive means. In terms of the management of gastrointestinal bleeding, there has been recent interest in the use of haemostatic forceps as well as endoscopic Doppler ultrasound. The application of Endoscopic Submucosal Dissection has expanded from its initial role in gastric cancer to the treatment of lesions in the oesophagus and colon. Therapy for Barrett’s oesophagus is moving ahead rapidly with the new HALO system performing radio-frequency ablation and the Spy-Glass is revolutionizing the management of biliary disorders. Natural orifice transluminal endoscopic surgery (NOTES) may be the way of the future with non-invasive or minimally invasive surgery potentially improving recovery times. This review will focus on all of these recent developments in the field of therapeutic endoscopy.