A new piece of tech has hit interventional GI. Here's why docs are raving about it
Key Takeaways
Industry Buzz
“Any device that demonstrates the ability to either make an accurate diagnosis or perform a therapeutic maneuver within a single procedure and prevents the need for a second procedure will have an impact in this field.” – Vinay Chandrasekhara, MD, Director of Advanced Endoscopy & GI Pancreas Groups at Mayo Clinic
“This will be a game-changer, as the current yields from the existing sampling modalities are not consistently great." – Samer Eldika, MD, board-certified gastroenterologist at Stanford
A new pancreaticobiliary endoscopy system could be a game changer in the field of biliary and pancreatic duct procedures.
The new technology, known as the Dragonfly system, has a 42% larger working channel diameter compared with current options and allows for 40% larger biopsy samples.[]
“There is a high level of enthusiasm for a novel pancreaticobiliary scope, particularly because this is not viewed as an iterative product, but rather purpose-built for pancreaticobiliary endoscopy,” says Vinay Chandrasekhara, MD, Director of Advanced Endoscopy & GI Pancreas Groups at Mayo Clinic and a spokesperson for the American Gastroenterological Association, to MDLinx.
“The design is meant to provide a large working channel to facilitate passage of accessory devices for diagnostic and therapeutic intent," Dr. Chandrasekhara says.
The new system will be introduced to selected clinical and academic centers across the US throughout the year.
Big impact in the field
Dr. Chandrasekhara has already used the device as part of an investigator-initiated research study not sponsored by the creators of the device. He says the Dragonfly endoscope has the potential to make a significant impact in the field.
“After many years of having a similar type of product from one manufacturer, we are suddenly experiencing increased competition with multiple pancreaticobiliary scopes. It's exciting to see this development, because this was once considered a very niche procedure. However, as endoscopists became more comfortable with this technique, the applications for and usage for cholangioscopy and pancreatoscopy have increased worldwide,” he says.
“Any device that demonstrates the ability to either make an accurate diagnosis or perform a therapeutic maneuver within a single procedure and prevents the need for a second procedure will have an impact in this field," he continues. "Another important feature is the design element that does not involve dials and ratchets, but, rather, turning the entire shaft of the scope mechanism. This will impact how the procedure is actually performed and it remains to be seen if this will improve the ergonomics of the procedure.”
"Many endoscopists suffer repetitive stress injuries, and the unique design elements of this scope may mitigate these concerns."
— Vinay Chandrasekhara, MD
The manufacturers claim the new device could improve diagnostic accuracy rates as well as clearance of stones in a single session.[]
A game-changing gastro device
Experts say that the 40% larger biopsy samples allowed by the device will be revolutionary.
“If that is the case, this will be a game changer, as the current yields from the existing sampling modalities are not consistently great,” Samer Eldika, MD, a board-certified gastroenterologist at Stanford with clinical interest in endoscopic procedures, tells MDLinx.
"The bile duct and the pancreatic duct are very tight spaces. As such, it is sometimes difficult to maneuver the currently available cholangioscope or pancreatoscope to guide an effective biopsy or lithotripsy.”Dr. Eldika says. “If it [the Dragonfly endoscopy system] is more agile in tight spaces, it might be more effective as a diagnostic or therapeutic tool."
A number of patient groups may benefit from the new technology. Dr. Chandrasekhara argues that those with biliary tract malignancy can be difficult to diagnose with the standard sampling techniques currently available.
“They often require multiple procedures to confirm a diagnosis of cancer. A more reliable device for accurately detecting cancer will have an immediate impact, as this allows patients to obtain a definitive diagnosis and undergo the appropriate treatment without delay,” he says.
“Another group of individuals who may benefit are those with large bile duct or pancreatic duct stones. Having a device that can clearly visualize these stones and then deliver accessories that can fragment the stone will improve the ability to clear either the bile duct or pancreatic duct within a single session.”
Potential challenges
However, the widespread benefit of the device may be restricted due to the cost of rolling out the device in clinical and academic centers across the country.
“Cost is a major consideration and limitation for broader adoption,” according to Dr. Chandrasekhara. “These types of devices will need to be covered by payers to ensure that the cost is not directly passed on to the patient.”
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