The SpyGlass® Direct Visualization System from Boston Scientific is the latest state-of-the-art technology in use by the gastroenterology department at Shannon Clinic.
The SpyGlass® is used by Shannon Gastroenterologists to examine the bile and pancreas ducts where biliary stones and cancers can occur. The system is equipped with a miniature 6,000-pixel fiber optic probe. It captures a full-color, 3-D image and can reach into the pancreatico-biliary anatomy.
Levi Hubble, MD, Shannon Clinic Gastroenterologist, received fellowship training for the SpyGlass device at Scott & White in Temple.
"It's an impressive technology," Dr. Hubble says. "This scope allows us to directly examine the bile and pancreas ducts which are difficult anatomies to reach in the body. The bile duct is very tiny—only three to five millimeters wide. We can examine bile duct strictures, which is a narrowing of the ducts, and biopsy and diagnose cancers involving the bile and pancreas ducts. This is also a tremendously helpful tool for breaking up bile duct stones."
Previously, this area was examined using conventional Endoscopic Retrograde Cholangiopancreatography (ERCP). A flat image was projected onto the screen which the physician would use to determine areas of concern.
"This technology helped me diagnose a rare autoimmune cholangitis which would not have been possible at our facility prior to using the SpyGlass®," Dr. Hubble says. "The patient was referred out to ensure he did not have an underlying mass, but we were able to send him to a specialist with a firm diagnosis."
If a biopsy was needed, a brush-like device was used to swab the area of concern. If additional therapeutic intervention was required, the patient was referred to a specialist outside of San Angelo for treatment. Now, the SpyBite® forceps attachment allows for a small piece of tissue to be taken from the area.
"With this technique, we can eliminate the need to send patients away for more invasive procedures," Dr. Hubble says. "For biopsies, the forceps allow us to look directly at the area we want to retrieve a sample from and we can determine if cancer is present. The capability to biopsy and reach this part of the anatomy provides a more adequate sample for pathology and also helps us rule out cancer and other diseases."
In addition to the fiber-optic probe and forceps, the SpyGlass® features a laser attachment used for laser lithotripsy. During this procedure, a pin-pointed laser is used to break up biliary stones, which are gallstones that have become lodged in the bile ducts.
"These stones can cause agonizing pain and other issues if left untreated," Dr. Hubble says. "The use of the laser to break up the stones eliminates the need for an open duct exploration which is a major procedure we would send the patients off for. It is invasive and can also cause future concern for the patient including bile duct strictures, which is a narrowing of the ducts that also requires surgical attention."
Most procedures involving the SpyGlass® take one to two hours as an outpatient, day surgery procedure, and are performed in the OR at Shannon Medical Center.
"Anytime we can bring a new technology to Shannon and to our area, that's a positive for our patients and for us as physicians," Dr. Hubble says. "This is a tremendously helpful tool that allows us to keep patients close to home while providing them with state-of-the-art care."
For more information, please call the Shannon gastroenterology department at 325.481.2277.