Surgeons performing endoscopy: why, how, and when?

Robert D. Fanelli, Mohammad Sulaiman Sultany


The last 20 years have witnessed significant advances in luminal endoscopy. Initially, flexible endoscopy was developed and utilized as a diagnostic tool. As new technology was developed, this platform served as the basis for therapeutic maneuvers, and in recent years, the flexible endoscope has been used to perform procedures that have replaced conventional surgical approaches. Additionally, still other techniques have been described de novo, launched on the flexible endoscopy platform. Some examples include transanal minimally invasive surgery, natural orifice transluminal endoscopic surgery, endoscopic metabolic surgery, and third space endoscopy. Throughout history, surgeons have played a vital role in the design and development of endoscopic techniques, procedures, and equipment. Surgeons continue to lead the advancement of flexible endoscopy as an interventional platform, providing significant contributions and serving as role models for innovation. In this review, we discuss the important heritage of endoscopy, its current and future uses, and the surgeon’s vital role as innovator and specialist.