Surgery, diagnostic imaging

Medica 2007: endoscopic advances make the unimaginable possible

3 October 2007

Whether in lab technology, electromedicine or medical IT, the latest developments are enabling things that seemed unimaginable just a few years ago.

Take, for example, the latest innovations in imaging, specifically in endoscopy. The smallest endoscopes have now shrunk to under a millimetre in diameter, enabling them to be inserted into the most delicate passageways of the human body. Whether to remove stones from the bile duct or to clear strictured salivary ducts, the mini endoscope can be used in even the tiniest of spaces.

The progress made in endoscopy in just a few years is highlighted by the range of accessories with which a mini endoscope can be fitted relative to its size. Today’s endoscopes feature light sources, lenses and two working channels through which, depending on requirements, forceps, a drill, a brush, a basket or a laser filament can be passed. Each piece of equipment is less than one millimetre in size — smaller than the diameter of a matchstick.

Professor Johannes Zenk, an ENT specialist at the University Hospital of Erlangen, who routinely handles such treasures of the precision and optical industries, expects these instruments to enable “new discoveries about the progress of disease.” The method used by Zenk, when he ventures into the 0.5-1.5 mm wide passages of the facial salivary glands with the help of a micro-endoscope, is known as 'small-caliber endoscopy'.

The ENT endoscopy specialist is particularly interested in the disease pattern of obstructive sialadenitis, an inflammation of the salivary glands caused in this case by stones which block the excretory duct of the major facial salivary gland. It is imperative that such stones are removed.

Zenk turns to endoscopic removal of stones in cases where it is not possible to break them up from the outside using bundled sound waves. He uses a mini hand-powered drill to hammer away at the stone until he can retrieve the fragments with a miniature basket. While Zenk uses an elastic device to expand strictures caused by other factors, he also uses the drill to remove tissue. The result of this operation is that more than 80% of patients remain symptom-free for many years.

Information about new products and exhibitor offerings, including the latest developments in endoscopy, is also available online before the start of Medica 2007, the 39th global medical forum and international trade fair and congress.

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