Endoscopy And The Future
Since the introduction of fiberoptic endoscopy in the mid-20th century, endoscopy and its role has progressed a lot. Initially endoscopes were used to see inside the lumen but with the introduction of endo-ultrasound, it is now possible to see beyond the lumen. Recently, in the last decade, third space endoscopy is gaining popularity where one can reach between the layers of the gastro-intestinal tract and perform various therapeutic procedures like removal of tumors and POEM for achalasia. In fact, endoscopy is now competing with surgery and endoscopists are performing various procedures without any incision which were the domain of surgeons at some time. These procedures have a lot of potential due to safety and minimal invasiveness.
ERCP is another form of endoscopy which is mainly used for diseases related to the pancreas and biliary system. Introduction of cholangioscopy has enabled us to look inside the biliary system. There are various manufacturing companies in India and abroad which manufacture or sell old refurbished or new endoscopes. For the Indian market, cost is a major issue. A large part of our population is poor and if cost of machinery, accessories, and maintenance is low the resulting cost of endoscopic procedures will be low. The second most important factor is post marketing service where majority of companies fail. After the selling of the product, the service records are poor, annual maintenance charges are too high, and a lot is charged for small accessories. This gives a bad name to companies and ultimately they suffer once their competitor comes in the market.
There is a recent surge in EUS-related procedures and third space endoscopy. The Indian market should be ready with this challenge and produce accessories related to these procedures rapidly. Bariatric endoscopy is also an attractive field and with time it will gain momentum. So, the industry should bring down the price of basic endoscopes and its accessories and should improve the service provided while at the same time be proactive in new developments in endoscopy like EUS, stents, and third endoscopy like ESD and POEM. The future is bright and many doctors are being trained in this field; the demand is going to increase day by day.
