Clinical Advances in Gastrointestinal Endoscopy

Dear Colleagues,

Gastrointestinal (GI) endoscopy has undergone significant advancements in recent years, revolutionizing the diagnosis, treatment, and management of various GI diseases. As a Guest Editor for this Special Issue, I am pleased to highlight the key developments and ask all of my colleagues to participate with their own work. These advances have been driven by innovations in imaging technology, artificial intelligence (AI), minimally invasive therapeutic techniques, and patient-centered approaches.

1. Advances in Imaging and Optical Technologies

One of the most remarkable improvements in GI endoscopy is the enhancement of imaging modalities, allowing for better visualization of mucosal and submucosal structures. Ultra-high-definition (4K) endoscopes provide superior image resolution, enabling the detection of subtle lesions that were previously difficult to identify. Additionally, chromoendoscopy and virtual chromoendoscopy (such as narrow-band imaging [NBI], blue laser imaging [BLI], and i-Scan) enhance contrast, making it easier to distinguish between benign and malignant lesions.

2. Artificial Intelligence in GI Endoscopy

AI has emerged as a transformative tool in GI endoscopy, improving lesion detection, characterization, and procedural efficiency. AI-powered systems enhance the identification of neoplastic lesions, Barrett’s esophagus, and early gastric cancer. Studies have demonstrated that AI-assisted endoscopy can improve adenoma detection rates (ADRs) and reduce the risk of missed lesions, leading to better patient outcomes.

3. Minimally Invasive Therapeutic Innovations

Endoscopic interventions have advanced beyond diagnostic applications, allowing for minimally invasive treatment of various GI conditions. Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) have become standard techniques and offer curative resection with minimal complications compared to surgery.

4. Advances in Therapeutic Endoscopy for GI Bleeding and Pancreaticobiliary Diseases

The management of GI bleeding has significantly improved with the introduction of hemostatic powders, over-the-scope clips (OTSCs), and novel coagulation techniques such as argon plasma coagulation (APC) and bipolar electrocoagulation. These innovations have enhanced the ability to control both acute and chronic GI bleeding effectively.

5. The Role of Capsule Endoscopy and Deep Enteroscopy

Capsule endoscopy has advanced significantly, allowing for better assessment of small bowel diseases, particularly obscure GI bleeding, Crohn’s disease, and small-bowel tumors. The introduction of AI-assisted capsule endoscopy interpretation has improved efficiency and diagnostic accuracy.

6. The Future of GI Endoscopy

As technology continues to evolve, the future of GI endoscopy looks promising. The integration of robotic endoscopy and remote-controlled capsule endoscopy may further enhance procedural precision and accessibility. Additionally, the role of AI-driven decision support systems in endoscopy is expected to expand, improving clinical workflow efficiency and reducing healthcare costs.

Dr. Ivan Žaja
Prof. Dr. Željko Puljiz
Guest Editors

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• endoscopy
• polyps
• EMR
• ESD
• POEM
• balloon dilatation
• coagulation
• imaging
• AI imaging