Endoscopic innovation through animal experiments: a new in-vitro platform.

Abstract

The development in endoscopy has been tremendous since the conceptof inspecting inside human's gastrointestinal tractfirst introduced in 1806. Flexible video endoscope became available with the advances in fiberoptics, image processing and technologies in CCD. In 1970s, the performance of sphincterotomy upon ERCP marked the start of the era of therapeutic endoscopy (1). The concept of en-bloc resection for early gastrointestinal cancers withendoscopic submucosal dissection (ESD) adopted the principles of surgery and applied through endoscopy using innovative instruments (2,3)). Natural Orifices Transluminal Endoscopic Surgery (N.O.T.E.S.) became the next logical step for the development of endoscopic surgery (4). The concept of N.O.T.E.S. is to achieve surgical procedures through the natural orifices of human body without skin incisions. This revolutionary idea, however, cannot be applied to human immediately as the feasibility, safety and effectiveness of these procedures were not completely understand. Animal model became a very important means to establish the achievability of new endoscopic diagnostic and therapeutic procedures (5). These in-vitro experiments, however, were limited by the use of large scale animals toaccommodate large diameter of an ordinary endoscope which is at least 9mm. Establishment of a tumor model in these large scale animal is extremely difficult when compared to nude mice models.