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SpyGlass technology offers better diagnosis
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Dr. Dan Kayal, above left, and Dr. Robert Hollis use the new SpyGlass technology to treat problems in the bile ducts and pancreas. |
For gastroenterologists, doing a bit of spying is helping them better diagnose and treat diseases of the bile duct and pancreatic duct in a less invasive manner.
"With SpyGlass technology, a fiber-optic camera, about the size of a pencil point, is passed through a standard gastrointestinal scope and threaded into the bile ducts or pancreatic duct," explained Dr. Daniel Kayal, a board-certified gastroenterologist with Medical Specialty Clinic.
"It has a host of applications, from allowing physicians to quickly and precisely locate and examine tissue of the bile duct without having to perform surgery to enabling doctors to quickly find and immediately clear obstructing stones within the biliary tract. The Spyglass Direct Visualization System is a technologically advanced device designed to enhance and accelerate diagnostic accuracy during ERCP."
An endoscopic-retrograde-cholangio-pancreatography, commonly called ERCP, is a procedure that allows the physician to diagnose or treat problems in the bile ducts and pancreas. An ERCP combines the use of x-rays and an endoscope to allow the physician to examine the bile duct and pancreatic duct, take tissue samples, remove stones and insert stents.
Compared to traditional ERCP, SpyGlass technology provides direct endoscopic imaging of the inside of the bile duct. The physician, for example, can take a tissue sample with direct visualization, which greatly improves the rate of diagnosis and reduces further testing and patient inconvenience. The technology was developed by Boston Scientific five years ago.
"Direct visualization significantly improves the chances of accurately diagnosing and treating a patient in one procedure, thus achieving the full potential of ERCP," said Dr. Kayal.
"SpyGlass is effective for access, direct visualization and biopsy of the bile duct. This technology can be used to differentiate malignant bile duct strictures from benign inflammatory biliary strictures. It's three-dimensional viewing technology has been shown to be useful in diagnosing pancreatic cancer, which is typically hard to diagnose in its early stages."
SpyGlass uses a light probe and miniature forceps to take tissue samples. This allows physicians to receive an enhanced view of the exact spot for biopsy, an advantage that is not possible with other diagnostic procedures. This helps physicians minimize the need for additional testing or repeat procedures. With no incisions made, the updated procedure is welcomed news for patients.
To remove stones in the bile duct, SpyGlass technology uses a fiber optic catheter that is passed through a standard gastrointestinal scope and threaded into the bile ducts or pancreatic duct. Once stones are identified, shockwaves are delivered through the catheter to break them up into pieces small enough to be removed safely.
Until now an open operation was the only alternative to remove larger stones that could not be removed by the standard approach.
"SpyGlass is a huge improvement for stone removal," said Dr. Kayal. "It allows for the removal of larger stones from the bile duct without an open surgery. This makes for a significantly shorter patient recovery time."
"SpyGlass also can diagnose bile duct cancer with 85 to 90 percent sensitivity," he continued.
At the end of the day, he said, it's about being able to tell a patient whether he or she has cancer.
"SpyGlass allows us to look for the first time at the bile duct, to take directed biopsies, which we have never been able to do. Cytology brushings samples of bile duct structures is all you have had to rely on for years and its sensitivity is probably 50 percent at best."