CHICAGO — Gastroenterologists in the market for a new device or game-changing technology were likely to find exactly what they were looking for — as well as a few cool surprises — on display in the exhibit hall at Digestive Disease Week. Here are 7 innovative advances I wouldn't mind having.

CapsoVision | CapsoCam Plus
Small-bowel diagnostics keeps improving thanks to advances in capsule endoscopy. With 4 on-board cameras and 16 LEDs, CapsoCam Plus provides twice the resolution of previous-generation CapsoCam capsules. The patient swallows the vitamin-sized capsule and goes home with only a retrieval system (no belts, harnesses or other wearable equipment), which includes a collection pan and magnetic wand used to recover the capsule. Upon collection, the patient returns the capsule to the doctor, who then downloads and analyzes the data. Capsule retrieval may be somewhat distasteful to some patients, and you have to consider the time required to sit down and analyze the data, but this could be a valuable first-line diagnostic tool for small-bowel diseases.

CDx Diagnostics | WATS^3D
This WATS^3D (Wide Area Transepithelial Sample with 3D Analysis) is more effective in the detection of Barrett's esophagus and dysplasia than forceps biopsy alone, says the company. It will increase your detection of precancerous abnormality of the esophagus when used as an adjunct to standard targeted forceps biopsy. The collection instrument is passed through the operating channel of a standard endoscope and adds minimal time to the overall procedure. A wide-sample brush biopsy designed to capture cells from a broader area, combined with a 3D imaging analysis (performed at a CDx Diagnostics lab), provides a comprehensive view of the cell structure to determine the presence of any abnormal cells. The turnaround for WATS^3D is typically 5 to 7 days.

Ethicon | Linx Reflux Management System
This anti-reflux device originally from Torax Medical (recently purchased by J&J's Ethicon) is a modern take on the Angelchik devices that have been around since the '70s for treating patients with chronic reflux, and this one is remarkably simple and durable. It's a small, flexible ring — about the size of a quarter — of titanium wire passing through a series of titanium beads, each with its own magnetized core. The device is laparoscopically implanted around the patient's lower esophageal sphincter; no alterations to the stomach are necessary. The ring expands to let food and liquid pass through the esophagus and into the stomach, and then magnetized beads come together to close the sphincter and keep acid and bile from coming up.

Lumendi | DiLumen Endolumenal Intervention Platform
This disposable colonoscope accessory may be a valuable tool for difficult colonoscopy cases. The design includes a flexible sheath and 2 inflatable balloons — one ahead of the distal tip of the scope (fore); and another behind the bending section of the scope (aft) — connected by 2 push rods. When both balloons are inflated, the device stabilizes and isolates targeted bowel segments to create a "therapeutic zone," as Lumendi calls it, for quick and localized insufflation. The GI doc can use the twin push rods to fully extend the fore balloon to flatten the mucosal folds and expose hidden lesions for diagnosis and treatment. After the procedure, you deflate both balloons.

Interscope | EndoRotor
The EndoRotor lets you use a single device to dissect, resect and collect large sessile polyps simultaneously. This eliminates the time needed to exchange instruments, and it may be a safer, easier alternative than a hot biopsy or snare when it comes to removing flat polyps. Compared with energy-based devices, which may cause thermal injury to adjacent tissue, the EndoRotor uses suction pressure to pull in mucosa and an inner rotating blade to cut it. Residual tissue, including lateral margins, can be evacuated to a specimen trap. Clinically, this may be useful in a minority of colon lesions, and may require a significant learning curve.

Pentax Medical | Slim Ultrasound Video Endoscope
This ergonomically engineered scope, combines the feasibility of Fine Needle Aspiration (FNA) with excellent ultrasound image quality, could be your next workhorse for everyday ultrasound endoscopic procedures. The EG-3270UK may be among the slimmest curved linear echoendoscopes available — maybe the slimmest — based on the diameters of the insertion tube (10.8 mm) and distal end (12 mm). The scope's shorter, tight-angle bending section and smaller distal end should make intubations more comfortable for patients having upper GI procedures, while the scope itself should be easier for your physicians to maneuver and advance. Maneuverability is important, but not if the visualization suffers. The EG-3270UK delivers reliable, high-resolution ultrasound imaging supported by elastography and Doppler technology.

Saneso | Smart Colonoscope
When it comes to endoscopy, every GI doc wants a better view. So when a company advertises a side-viewing, backward-viewing scope offering a 360 ? view, you pay attention. The Smart Colonoscope from Saneso uses 5 cameras for a multidirectional view of the GI tract, meaning you can see front to back, side to side and into the mucosal folds. The scope offers a number of bells and whistles, including advanced lighting options — a "select band imaging" feature lets the GI doc examine lesions using the spectrum of his choice, while the "dual band imaging" feature lets the doc use 2 spectra during a single withdrawal — and "shadow casting," a depth-enhancement feature that identifies hidden polyps by the shadows they cast. Saneso expects FDA approval to come through later this year.

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Look What Else We Saw at Digestive Disease Week

3D App for Lifelike GI Training
Gastro Ex, a virtual surgery mobile app from Level Ex, lets GI specialists practice performing endoscopies, conducting biopsies and cauterizing tissue, among other procedures. Inspect, inject, grab, cut, laser and lasso — only you're doing all of the above on a 3D gastrointestinal tract rather than an actual patient, thanks to the same technology used in the architecture of high-def video games. Designed specifically for practicing GI docs with an affinity for smartphones and tablets, Gastro Ex is ideal for advancing a doc's skill level performing endoscopic procedures, as well as for earning CME credits.

Go-to Wire Guide
Cannulating a biliary or pancreatic duct should be a cinch with this flexible wire-tipped guide. Cook Medical borrowed from its expertise in interventional radiology technology when it designed the single-use Acrobat 2, which the company describes as "an everyday, go-to wire guide." Available in straight and angled-tip versions, the newly launched Acrobat 2 helps clinicians negotiate the pancreaticobiliary anatomy for even the most challenging ERCP procedures. Hallmark features: a platinum spring-coil tip — designed to be gentle on delicate tissue — which serves as a landmark during fluoroscopic visualization; a 5.8 cm hydrophilic coating to reduce friction as it advances through the patient's anatomy; and a thicker core that makes it resistant to kinking and, as a result, improves "pushability." The Acrobat 2, which can also be used during sphincterotomy, is available in diameters of 0.025 and 0.035 inches and lengths of 205 cm, 260 cm and 450 cm.

Optimal Endoscopic Imaging
Fujifilm's latest endoscopic ultrasonic processors, under the Sonart SU-1 banner, offer next-generation imaging in a compact footprint. Available in 2 models, the SU-1 and the SU1 Platinum, these processors let you visualize surrounding anatomical structures — "seeing beyond the wall and through the wall," as a company rep describes it — to aid in diagnosis and treatment. The SU-1 is all about options. Imaging modes include the use of harmonic imaging, which reduces "noise" and enhances fields of tissue both near and far; Color Doppler, a hemodynamic view that highlights blood flow in a specific observation site; and elastography (SU-1 Platinum only), which displays the stiffness levels of observed tissue as different colors. Additionally, clinicians can use full-screen GI, full-screen endoscopic ultrasound and picture-in-picture viewing options. Each unit is available in 2 keyboard options — a touchpad or the more traditional trackball — and has a USB slot for archiving captured still and cine images.

Rapid-Deflation Balloon Dilator
Crystal-clear visualization and speedy withdrawal during balloon endoscopy — that's what Elation balloon dilators from Merit Medical Endotek offer. Available in fixed-wire and wire-guided varieties, each of these single-use balloon dilators has 3 stages of dilation to improve visibility in even the trickiest strictures, as well as radio-opaque marker bands to serve as guideposts during fluoroscopy. Perhaps the device's greatest strength is its quick deflation time. The balloon deflates completely in 6 seconds, or as little as half the time of some other balloon dilators, says the company.

Specialized Sphincterotomes
For smooth and simple access during ERCP procedures, there's Olympus's pair of new CleverCut 3 V sphincterotomes. Designed for use with Olympus's VisiGlide guidewires, these 2 wire-guided sphincterotomes have specialized cannulation tips — an oblique tip and a short bend tip — designed to facilitate cannulation. The CleverCut 3 V with the oblique tip aligns the axis of the sphincterotome with the bile duct, without unnecessary manipulation of the pancreatic duct, while the short bend tip enables a surer approach to cannulation when the scope is in a difficult position. Also, for matters of safety, each sphincterotome has a pre-curved tip for stable cutting and a special coating on the cutting wire's proximal end to preserve surrounding tissue.

— Bill Donahue