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Spyglass (Esophageal Cancer)

Spyglass technology improves the physician's view of the pancreas and bile ducts. Almost half a million people annually in the United States undergo a procedure called ERCP to diagnose problems in their liver, gallbladder, pancreas and bile ducts.

Physicians at St. Joseph's Cancer Institute are now using a new technology called SpyGlass® to improve diagnosis and treatment for conditions such as obstructions and stones within the pancreatico-biliary system.

The SpyGlass Direct Visualization System includes a miniature 6,000-pixel fiber optic probe that provides physicians with a direct view of a patient's pancreas and bile ducts, overcoming some of the visual challenges of conventional ERCP procedures.

As part of the traditional ERCP procedure, physicians use an endoscope - a long, flexible, lighted tube that is inserted through a patient's mouth and directed through the stomach - to view the entrance to the pancreatico-biliary system. After injecting a water-soluble contrast into the common bile duct, X-rays may be taken of the pancreatico-biliary system. However, these X-rays are two-dimensional images that often do not provide enough information to obtain a complete diagnosis.

During some procedures, physicians may need to pass small catheters to obtain tissue samples.  Data shows that up to 30 percent of ERCPs performed using brush cytology or biopsy forceps for tissue diagnosis are inconclusive, potentially creating the need for additional testing or repeat procedures. Besides being inconvenient for patients having to return to the hospital, the procedure can take two or more hours and typically requires the patient to not eat or drink for six to eight hours beforehand.

Using the SpyGlass system, Mercy San Juan physicians insert a miniature fiber optic probe (roughly the width of 10 human hairs) into the bile duct through a steerable catheter. The miniature probe is designed to allow the doctor to see directly inside the biliary ducts to identify and assist in diagnosing obstructions caused by tumors or stones. The ability of the physician to take optically-guided biopsies in the bile duct has been shown through clinical data to increase the likelihood of obtaining an accurate diagnosis over tissue samples obtained under fluoroscopy (X-ray).