Future Innovations and Techniques: Endoscopic Hemostasis for UGI, Non-Variceal Bleeding

Future developments and innovations in the field of endoscopic hemostasis for upper gastrointestinal bleeding need to be based on an understanding of the efficacy and limitations of current methods and on an understanding of the vascular pathology of bleeding abnormalities. Currently there is a need for more effective hemostasis, especially for bleeding vessels of 1 to 4 mm in diameter which cannot be stopped by injection or thermal methods. There is likely to be an increasing requirement for effective hemostasis at flexible endoscopy in part due to changing disease patterns and also due to an increasing use of flexible endosurgery for example endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) and transgastric approaches. This article reviews potential improvements in mechanical, thermal, and injection methods that may lead to improvements in flexible endoscopic hemostasis in the upper gastrointestinal tract.