Feasibility of a Single-operator Peroral Cholangiopancreatioscopy System (SpyGlass)

Cholangioscopy, or direct visualization of the bile ducts was first documented in the late
1970s and has made many advances over the last few decades. The advent of mother-baby scopes
allowed for both diagnostic and therapeutic procedures, though the early scopes were often
fragile, and cumbersome due to the need for two endoscopists. Ultraslim endoscopes later
became popular as a method to digitally view the bile ducts, however, often needed guide-wire
or balloon-assistance to allow for cannulation. Other disadvantages of these systems included
limited steerability, and poor irrigation capabilities.

The advent of Spyglass, a single-operator peroral cholangioscopy method allowed for a
fiberoptic, catheter-based system that could be easily used for diagnostic and therapeutic
purposes in the biliary system. However, image quality was often lacking due to the
fiberoptic technology. The new digital Spyglass system rectifies this inadequacy by
introducing a digital sensor for better image quality, which will allow for better
visualization and diagnosis of indeterminate strictures. Furthermore, modification of the
scope platform allows for efficient use, reliable directionality of the scope tip, and
improved ease of passage of accessories during therapeutic procedures such clearing stones or
stent placement.