Endoscopy Technology: Is Your Suite up to Date

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Endoscopy Technology

Editor’s note: The following article highlights companies and the new technologies that they are developing for endoscopy. With video imaging improving rapidly, endoscopy suites are expected to provide the most efficient service. Better photos equal better care. Is your suite up to date?

Companies often expand after figuring out how to improve other markets. In the case of Fujinon, company officials helped create a market.

  • In 1944, the Fuji Optical Co., Ltd was established to develop optical instruments to accompany the film already produced by Fuji Photo Film Group. The company’s scientists knew how to make a high-quality film, but they wanted to meet this technology with an improved camera and other optical instruments.
  • Some 50 years later, this innovative spirit has helped push the company to the forefront of endoscope manufacturing.
  • In April 1971, Fujinon developed and commercialized its first endoscope. Within the past 30 years, Fujinon’s products and systems have gone through a world of development.
  • In May 1985, the company showcased one of the first video endoscopes at the Digestive Disease Week conference and in May 1989, they released a super image video endoscope at the Gastroenterological Endoscopy Show in Japan.
  • Today, they offer one of the highest pixel counts available in endoscopes.

Their products have gone from basic rigid scopes to the …400 series endoscopy systems that include scope, light source, and processor. Other new Fujinon products include the EG-250HR gastroscope. The outer diameter of the instrument has been reduced to 9.4mm. The forceps channel diameter is 2.8mm. The smaller diameters make patients more comfortable and let the endoscopy team spend more time concentrating on the procedure, rather than the nervousness of its patient.

The EG-250PE also is new on the market. The pediatric video-gastroscope has a variety of applications and has a flexible portion diameter of 8.1mm.

The company is also promoting its new maintenance and repairs guarantee offered with each new …200 or …400 series endoscopic systems. When a healthcare center buys, leases, or acquires (on a cost-per-procedure basis) one of the systems, the company will now include a “Full Circle Commitment” on each product. This includes a complete inspection, preventive maintenance, and routine repairs. Each scope will have an A-rubber exchange, nozzle replacement, angulation adjustment, and an outgoing quality assurance inspection twice a year.

Each service also includes a loaner scope so healthcare centers do not have to worry about rescheduling appointments. Shipping will be paid by the company as well to make sure both scopes are delivered on time. Also, when the company has a representative available, light source and processor service is also available on site.

There is no charge for this program.

  • The difference between the …200 and …400 systems is a matter of technology. The …200 series are designed for ambulatory and outpatient surgical centers. The models feature 410,000-pixel charge coupled devices (CCDs) and produce analog images. The scopes use the same combined light source and video processor. These instruments will work with all previous, current, and future endoscopes within the series under the company’s modular system integration program.
  • The …400 series are the highest end of endoscopes on the market. They produce digital images with 410,000-pixel CCDs. They have 35X optical zooms and let the endoscopy team fill the monitor with any minute feature they want to examine more closely. The light source used with this system is xenon and the backup light is halogen. The video processor also has features to control image capture. The system also has a microprocessor for patient scheduling, image storage, and presetting individual control preferences for each endoscopist.
  • This series also contains a group of scopes with twice the pixel count as any other scope in the world. These 850,000-pixel CCD endoscopes are usually used in teaching and research institutions.
  • The same program applies for the …400 series as well. All past-present-future equipment will be compatible with each other.
  • Each series has a variety of scopes available including bronchoscopes, gastroscopes, duodenoscopes, colonoscopies, sigmoidoscopies, and laparoscopes.
  • The systems range in price from $12,000 to $24,000.
  • The vice president of Fujinon, Eric Knisley, says these scopes will help the overall health of patients by giving endoscopists the power to more closely examine their patients, with the technology of seeing the images clearly, and being able to store them for later reference.

“The increased resolution achieved by the new … series scopes can easily change endoscopic outcomes for practicing endoscopists. Improved image quality and resolution significantly enhance diagnostic yields, which provide much earlier detection of previously unseen abnormalities. These results clearly improve patient management and ultimately reduce healthcare costs,” he said.

Resource Guide

The following companies also manufacture endoscopes and accessories:

  • AngioLaz Medi-Vu www.angiolaz.com
  • Cuda Fiberoptics www.cuda.com
  • Integrated Endoscopy www.iescope.com
  • Karl Storz Endoscopy www.karlstorz.com
  • Richard Wolf www.richardwolf.com
  • ROSOT Enterprises www.rosot.futurahost.com
  • Rubicon Medical www.rubiconmed.com
  • SH Medical Corp. www.shmedical.com
  • Solos Endoscopy www.solosendoscopy.com
  • Surgical Optics, LLC www.surgical-optics.com
  • Vision Sciences, Inc. www.visionscience.com
  • Wilson Cook www.cookgroup.com

Olympus America, the distributor-manufacturer of optical instruments, has introduced a new endoscope that features variable stiffness to meet the anatomy and physical conditions of the patient.

Innoflex™

Innoflex™, the world’s first variable stiffness colonoscope, adapts to the contours of the colon for precise insertion. The colonoscope is part of the Olympus EVIS EXERA™ system and has been heralded as a crucial instrument for the treatment of the aging baby boomer population. With colorectal cancer rates increasing and the pool of retired Americans quickly growing, innovation in the area of colonoscopes is necessary.

Also, the difficulty most physicians and endoscopy teams report concerning colonoscopy is that the characteristics and anatomy of a patient’s colon are not known before the procedure. An endoscope needed to be developed to be able to function for patients with varying anatomies and gastroenterological health issues.

Olympus

  • Olympus engineers developed a scope with a variable stiffness feature to tackle these problems.
  • In an article from the Journal of the British Society of Gastroenterology (GUT) featured a recent study of 100 patients and the variable stiffness colonoscope. Of 100 cases, 43 were performed with conventional colonoscopy (Olympus CF200HL) and 57 were performed with the new variable stiffness colonoscope. There were four incomplete examinations with the first group (two sigmoid fixations, two benign strictures). There were also two incomplete procedures with the second group (one cancerous obstruction, one fixed sigmoid). All but one of these patients were able to use a pediatric scope instead.
  • Of those patients who received the variable stiffness scope, the intubation time was quicker by more than four minutes in comparison to the other group using a traditional colonoscopy. The pain scores with the variable stiffness group were also less. They had a median pain rate of seven in comparison to the traditional group’s rate of 24.
  • From this study, the researchers concluded that the variable stiffness colonoscope improved the performance of the procedure by reducing intubation time and discomfort.
  • Olympus officials report the scope works by letting the gastroenterologist or the physician adjust a knob for tube flexibility. The knob, which is located below the control section, can be adjusted in continuous increments to match the internal conditions and contours of the colon. The cecum can be reached more easily in cases where insertion is difficult and there is a reduced need for abdominal pressure and position change.
  • The scope also has an extra-wide 140º field of view and extensive 4-way angulation (180º up/down and 160º right/left) to enable complete examination of the colon and the grip of the scope has been designed with ergonomics in mind. The insertion tube is actually able to change stiffness levels because of a built-in coil. This decreases the chance of looping and makes insertion beyond the splenic flexure easier, while reportedly reducing the need for abdominal pressure on the sigmoid looping.

Ken Wolcott, senior product manager from Olympus America said physician response to the new technology has been positive.

“Throughout the world, physician response to the Innoflex has been overwhelming. We continually hear success stories from physicians who have decreased their time to reach the cecum and sales of the variable stiffness models have now exceeded sales of conventional colonoscopes,” he said.

Olympus is a registered trademark of, and EXERA and Innoflex are trademarks of, Olympus Optical Co., Ltd.

Reference

  •  Brooker, JC, Saunders, BP, SHAH, SG, and Williams CB. “A new variable stiffness colonoscope makes colonoscopy easier: a randomized controlled trial.” Journal of the British Society of Gastroenterology. June 2000. vol. 46. pp. 801-805

Image management was first introduced by Pentax in 1987, allowing findings observed during an endoscopy procedure to be captured as still images. These subsequently can be reviewed, shared, and indexed in a computer database. Today, Pentax offers endoscopy suites the next level of image management in motion picture studio technology (MPS), more commonly known as video streaming. This capability goes beyond still images, offering motion video documentation, which can be saved and recalled using a computer. MPS can record an entire procedure and create video highlight summaries with the touch of a button. Image indexing, annotation, and video editing are just some of the capabilities this new tool presents.

Applications

Operated in conjunction with Pentax’s endoPRO® and Doc-U-Scribe® systems, users can print and view patient information and schedules as well as capture and store still images and video clips. This eases records management and facilitates the transfer of information between physicians and staff while increasing both workflow and productivity. Whether in a one-room clinic, or a multi-room endoscopy suite, MPS can be used to effectively link data between users and workstations.

Not only does video streaming facilitate better practice management, but it can provide a significant clinical advantage as well. It is often difficult to determine the size of strictures and lesions when viewing endoscopic images through a scope, due to the distortions that take place during angling. However, with video streaming, a 30-second motion picture sequence allows for points of reference to be established, reviewed, and compared for as long as the records are kept. Moreover, these images can be shared between referring physicians to further continuity of care.

In addition to its usefulness in examining and resecting tumors and biopsies, it provides a myriad of applications for medical academia. Specific images can be marked for recall, annotated with notes for teaching, indexed for convenience, and then reproduced for utilization in academic presentations and publications.

Another distinct advantage to this technology is that since information is stored digitally, indexing and transmission of data throughout networks and over the Internet become immediately possible.

Improved Imaging

The quality of the endoscopic images provided through video streaming is impressive. Hayk Esenyan, director of new technologies at Pentax comments, “The ability to perceive high quality, temporal characteristics of an endoscopic subject through video streaming carries great advantage both during procedures and in the later review. In addition, the endoscopic information captured in video streaming is more comprehensive than that obtained through prior technologies. The image quality is sharper and the information obtained is more representative of the procedure as a whole.”

Summary

In light of the improvements that video streaming can bring to image management, it is no surprise that this technology is quickly gaining consideration as an indispensable tool for the field of endoscopy.

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Category: Equipment

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