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Tuesday, June 21, 2011 - New ‘SpyGlass’ Fiber Optic Technology Makes Hard-to-Detect GI Problems Easier to Diagnose

Article by Jeffrey Gilbert, M.D., and Mark Prince, M.D.

Each year, almost half a million Americans undergo a procedure called ERCP (endoscopic retrograde cholangiopancreatography), which is performed to diagnose cancer, stones, and other disorders of the liver, gallbladder and bile ducts. Conventional ERCPs may be inconclusive, and additional tests or even surgery may be necessary to determine the nature of a patient’s problem.

Local gastroenterologists are now turning to the new SpyGlass™ Direct Visualization System in many cases because it addresses the limitations of conventional ERCPs.  


Conventional ERCP

One of the most common reasons for performing ERCPs is to evaluate the bile ducts for possible problems. Bile ducts are narrow tubes that carry bile, a fluid that is necessary for digestion. The liver produces this substance, and the gallbladder stores it until the body needs it to digest fat. When physicians suspect a problem and want to visually examine this area, they typically insert an endoscope – which is a long, flexible, lighted tube -- through the patient’s mouth and stomach and into the entrance of the bile ducts. Contrast dye is injected, and x-rays may be taken.          

One of the drawbacks of the procedure is that x-rays are two-dimensional black-and-white images. They do not always provide the doctor with enough information to make an accurate diagnosis. When a procedure is inconclusive, the physician may recommend additional tests or even exploratory surgery in order to determine the nature of the problem and prescribe the most appropriate treatment.

                       

A Significant Improvement

The new SpyGlass system is a significant improvement over conventional ERCP in certain cases. While not replacing conventional ERCP, it can be beneficial when used appropriately. SpyGlass allows a doctor to examine portions of a patient’s digestive system with greater accuracy through the use of a fiber optic probe that is attached to a camera. The doctor inserts the probe, which is about the width of 10 human hairs, into the bile duct through a steerable catheter.

He or she can directly view high-quality images from inside the bile ducts. The images are very similar to those that a doctor would see on a video screen. With this level of detail, the physician can more easily determine a patient’s problem; perform a biopsy; and even break up and remove large stones without the need for additional procedures, including surgery.

The new fiber optic system is still unavailable to most Americans who might benefit from it. Less than 400 facilities in the entire country have the technology, and very few physicians have the training to use it. As more health professionals recognize the benefits of the new technology, however, the standard of care for GI patients in this country may dramatically improve within the next few years.

For patients in Oak Ridge and surrounding areas, SpyGlass already is making a difference. GI problems can, in some cases, be diagnosed and treated during one highly accurate test. The test is generally more convenient for patients because they do not need to return to the hospital for additional procedures; and patients’ comfort level is much better.

While SpyGlass technology hasn't reached many parts of the country, Methodist's GI physicians are already utilizing this beneficial equipment. To learn more about the physicians offering this service or for a physician referral, call (865) 835-4662.