Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-05-21DOI: 10.5946/ce.2024.332
Kihyun Ryu, Won Jae Yoon, Sang Hoon Kim, Da Hee Park, Jin Hwa Park, Ki Bae Bang, Tae Joo Jeon, Da Hyun Jung, Young Sin Cho
{"title":"Current status and trends of green endoscopy.","authors":"Kihyun Ryu, Won Jae Yoon, Sang Hoon Kim, Da Hee Park, Jin Hwa Park, Ki Bae Bang, Tae Joo Jeon, Da Hyun Jung, Young Sin Cho","doi":"10.5946/ce.2024.332","DOIUrl":"10.5946/ce.2024.332","url":null,"abstract":"<p><p>The increasing global emphasis on sustainability has extended its influence to the field of medicine, including endoscopy. Green endoscopy aims to minimize the environmental footprint of endoscopic practices while maintaining high standards of patient care. This review examines the current status of green endoscopy, focusing on its environmental impact, strategies for waste reduction, and adoption of sustainable practices. The key topics include the environmental challenges posed by single-use devices, the role of sterilization and recycling, and innovations in energy-efficient endoscopic equipment. Furthermore, we highlight policy recommendations and actionable strategies for healthcare systems to transition toward green practices. By integrating these approaches, the field of endoscopy can meaningfully contribute to global sustainability efforts without compromising clinical outcomes.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"493-502"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fabrication and mechanical testing of polydioxanone hook cross biodegradable self-expandable enteric stent: impact of fabrication density and mechanical properties of the stent.","authors":"Tanyaporn Chantarojanasiri, Juthamas Ratanavaraporn, Saran Keeratihattayakorn","doi":"10.5946/ce.2024.252","DOIUrl":"10.5946/ce.2024.252","url":null,"abstract":"<p><strong>Background: </strong>The mechanical properties of biodegradable stent when fabricated using different number of pins per row of fabrication has been limited. We compared the radial compressive force of polydioxanone (PDO) stent that was fabricated in hook and cross manner, using 13, 17 and 19 pins per row and measure the radial compressive force and ex vivo deployment.</p><p><strong>Methods: </strong>The PDO stents fabricated by the in-house aluminum mandrel were tested for radial force using plate compression until the stent achieved 50% strain. The relationship between compression force and %strain was calculated. Ex vivo testing of stent expansion against short segment stricture was performed in a pig small intestine compared between PDO hook cross PDO stent and braided metallic stent.</p><p><strong>Results: </strong>The stent shortening of 16.40%, 31.20% and 19.24% was observed in 13-, 17- and 19-pin-per-row, respectively. The maximum force to achieve 50% strain were 0.503, 1.168 and 1.008 N for 13, 17 and 19 pins per row, respectively. The stent fabricated using hook and cross pattern demonstrated higher conformability to anatomical stricture when compared with braided stent.</p><p><strong>Conclusions: </strong>PDO stent fabricated using 17 pins per row demonstrated highest radial force when compared with 13 and 19 pins per row.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"586-594"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-06-04DOI: 10.5946/ce.2024.295
Sang Un Kim, Seong Woo Jeon
{"title":"A new hemostatic device for gastric endoscopic submucosal dissection: a prospective randomized controlled trial comparing Coajet and Hemograsper in Korea.","authors":"Sang Un Kim, Seong Woo Jeon","doi":"10.5946/ce.2024.295","DOIUrl":"10.5946/ce.2024.295","url":null,"abstract":"<p><strong>Background: </strong>Gastric endoscopic submucosal dissection (ESD) is often accompanied by bleeding. Coajet, a new device containing an injection needle, has been found to be useful in achieving hemostasis through monopolar contact. This study aimed to evaluate the efficacy and safety of this new hemostatic device by comparing it to hemostatic forceps (Hemograsper).</p><p><strong>Methods: </strong>This prospective, randomized, single-center study enrolled consecutive patients scheduled to undergo gastric ESD from February 2022 to January 2023. The Hemograsper group (HG) underwent hemostasis using the conventional method, whereas the Coajet group (CG) used this new tool for lesion marking, submucosal injection in the initial stage of ESD, and then for hemostasis.</p><p><strong>Results: </strong>A total 56 patients were enrolled in this study (HG, 28; CG, 28). No significant differences in age, sex, diagnosis, location, endoscopic size, or morphology were observed between the two groups. No significant difference in total operative time (HG, 16.0±6.9 minutes vs. CG, 12.4±6.7 minutes; p=0.05) and hemostatic time (HG, 186.6±134.5 seconds vs. CG, 130.4±81.5 seconds; p=0.06) were observed between the two groups. No differences in other procedure-related variables, such as complete en-bloc resection rate, length of admission, grade of immediate bleeding, and delayed bleeding within 30 days (HG, n=1 vs. CG, n=1), were noted.</p><p><strong>Conclusions: </strong>The new hemostatic device, Coajet, showed comparable efficacy to that of conventional hemostatic forceps for bleeding control and the prevention of delayed bleeding in gastric ESD.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"58 4","pages":"552-560"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-06-16DOI: 10.5946/ce.2025.061
Hyung Ku Chon
{"title":"From dogma to individualized care: the potential of 6-mm fully covered self-expandable metal stent in unresectable malignant distal biliary obstruction.","authors":"Hyung Ku Chon","doi":"10.5946/ce.2025.061","DOIUrl":"10.5946/ce.2025.061","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"58 4","pages":"630-631"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-04-24DOI: 10.5946/ce.2024.343
Matteo Marasco, Gianluca Esposito, Marianna Signoretti, Maria Rinzivillo, Francesco Panzuto
{"title":"A systematic review on endoscopic ultrasound in gastric neuroendocrine neoplasms: guidelines outpacing evidence.","authors":"Matteo Marasco, Gianluca Esposito, Marianna Signoretti, Maria Rinzivillo, Francesco Panzuto","doi":"10.5946/ce.2024.343","DOIUrl":"10.5946/ce.2024.343","url":null,"abstract":"<p><strong>Background: </strong>Gastric neuroendocrine neoplasms (g-NENs), though rare, have shown a rise in incidence due to increased endoscopic screening and improved diagnostic awareness. International guidelines recommend the use of endoscopic ultrasound (EUS) in managing g-NENs to evaluate subepithelial lesion size, depth, and lymph node involvement before endoscopic resection. However, the supporting evidence for EUS's role in g-NENs is scarce and limited.</p><p><strong>Methods: </strong>According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was conducted on PubMed to identify studies about the role of EUS in g-NENs, including both retrospective and prospective human studies.</p><p><strong>Results: </strong>A total of 355 studies were considered; however, only seven studies focusing on EUS's diagnostic utility in g-NENs were selected, including only 44 patients. EUS showed promise in assessing tumor characteristics critical for endoscopic resection. Nevertheless, its diagnostic accuracy remained variable across lesion types, and its impact on clinical decision-making in g-NENs lacked robust evidence. EUS contributed to subepithelial lesion staging but was underrepresented in neuroendocrine tumor-specific studies, creating a knowledge gap.</p><p><strong>Conclusions: </strong>This review underscores the need for larger multicenter studies to validate EUS's efficacy and reliability in g-NEN management. Prospective trials are crucial to strengthen guidelines and provide clearer clinical guidance for managing these tumors.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"525-532"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-07-04DOI: 10.5946/ce.2025.133
Seung Min Hong, Dong Hoon Baek
{"title":"Spirals and balloons: a new chapter in deep enteroscopy?","authors":"Seung Min Hong, Dong Hoon Baek","doi":"10.5946/ce.2025.133","DOIUrl":"10.5946/ce.2025.133","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"546-548"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical EndoscopyPub Date : 2025-07-01Epub Date: 2025-05-20DOI: 10.5946/ce.2024.324
Kerem Parlar, Mert Cakir, Ozlem Ozer, Prateek Sharma
{"title":"Future of image enhanced endoscopy of esophageal adenocarcinoma.","authors":"Kerem Parlar, Mert Cakir, Ozlem Ozer, Prateek Sharma","doi":"10.5946/ce.2024.324","DOIUrl":"10.5946/ce.2024.324","url":null,"abstract":"<p><p>Barrett's esophagus is a premalignant precursor lesion of esophageal adenocarcinoma that affects approximately 1% of the population worldwide. Esophageal adenocarcinoma has a high mortality rate with a five-year survival of 15% to 20%. Early detection of Barrett's esophagus and dysplasia via endoscopy is crucial for preventing its progression to esophageal adenocarcinoma. New imaging techniques, such as image-enhanced endoscopy, have simplified the identification of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma. Narrow-band imaging, blue-light imaging, and i-Scan are the prominent image-enhanced endoscopic techniques used to detect neoplasia. In Barrett's screening and surveillance, key aspects such as the screening population, tools, and intervals need to be clearly defined and standardized for future guidelines to improve the detection of precursor lesions and reduce the incidence of esophageal adenocarcinoma. Making image-enhanced endoscopy less subjective and enhancing the quality measures during endoscopy are crucial steps. Examples of quality measures include cleaning the esophagus before endoscopy and allowing sufficient time for inspection. Artificial intelligence systems can aid the early identification of lesions and reduce subjectivity.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"503-513"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"True natural orifice transluminal endoscopic surgery-transgastric cholecystectomy and beyond.","authors":"Pingting Gao, Jia Yu, Mingyan Cai, Lili Ma, Quanlin Li, Pinghong Zhou","doi":"10.5946/ce.2024.352","DOIUrl":"10.5946/ce.2024.352","url":null,"abstract":"<p><p>Natural orifice transluminal endoscopic surgery (NOTES) represents a revolutionary advancement in minimally invasive surgery, eliminating the need for external incisions and offering faster recovery and improved aesthetics. Endoscopic transgastric cholecystectomy (ETGC), a NOTES-based procedure, stands out for its potential to revolutionize gallbladder removal by offering a truly scarless alternative to traditional laparoscopic cholecystectomy (LC). This review explores the historical development of cholecystectomy, evolution of NOTES, and emergence of ETGC as a feasible alternative to LC. We highlight the technical refinements that have enabled ETGC, including innovations in full-thickness resection and suturing techniques, and discuss challenges such as visibility, orientation, and wound closure. Finally, we examine the role of robotic platforms in enhancing precision and expanding clinical applications by positioning ETGC as a transformative technique in the era of minimally invasive surgery.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"58 4","pages":"518-524"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}