Dr. Gross is currently involved in a study that's comparing these
adjuncts with conventional colonoscopy. "Anecdotally they may have
value, but truthfully we need objective data based on an extended
number of cases to determine if they have staying power," he says.
"The add-ons might not be appropriate or accepted by all endo-
scopists, but perhaps underperforming physicians would benefit the
most from enhanced images, larger fields of view or mechanical
enhancement of the colonoscope."
Dr. Johnson points to the potential of optical biopsy platforms,
which involve the mid-screening resecting and discarding of pre-
sumed low-risk polyps based on appearance without having to submit
them to pathology. "That would save time and expense," he adds.
"Optical biopsy presents an opportunity to decrease the overall cost
of colonoscopy and tissue removal."
Getting rid of reflux
Finally, there's a renewed focus on providing patients with
relief from the dangerous burn of acid reflux. Adrian Park, MD, chair
of the department of surgery at the Anne Arundel Medical Center in
Annapolis, Md., says 40 to 60% of the general population experience
reflux symptoms. About 10% of those individuals who do not respond
to a stepwise approach of dietary and lifestyle modifications require
treatment with anti-reflux medications. The 1% who will fail to
respond to medical therapy are candidates for interventional therapy,
says Dr. Park.
He says there was great interest in endoluminal approaches for the
treatment of GERD about 10 to 15 years ago and a flurry of clever
products were developed to buttress or embellish the lower
esophageal sphincter — the valve between the esophagus and stom-
ach that plays a significant role in the control of reflux. The solutions
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