Futuristic endoscopy suite featuring forward-oblique view echoendoscope in action.

Beyond Standard Procedures: How a New Scope is Changing GI Endoscopy

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"A forward-oblique view echoendoscope is streamlining complex gastrointestinal procedures, reducing time and improving outcomes for patients with advanced pancreatic cancer."

For individuals facing advanced pancreatic cancer, the combination of malignant biliary obstruction and gastric outlet obstruction presents significant challenges. Traditionally, addressing these conditions required multiple endoscopic procedures, increasing both the complexity and duration of treatment.

A recent study highlights a streamlined approach using a forward-oblique view echoendoscope. This innovative tool allows for the simultaneous placement of duodenal stents and endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), offering a more efficient solution for patients with these complex conditions.

This article delves into how this advanced technique is transforming the landscape of gastrointestinal (GI) endoscopy, reducing procedure times, and potentially improving patient outcomes. We’ll explore the benefits, the technology behind it, and what it means for the future of cancer treatment.

The Innovative Forward-Oblique View Echoendoscope: A Game Changer

Futuristic endoscopy suite featuring forward-oblique view echoendoscope in action.

The core innovation lies in the forward-oblique view echoendoscope (EG-580T; Fujifilm, Tokyo, Japan), a device that merges the capabilities of traditional forward-viewing and oblique-viewing endoscopes. This unique design allows gastroenterologists to visualize both the enteric stricture for duodenal stent placement and facilitate EUS-guided biliary drainage during hepaticogastrostomy.

Traditional methods often involve sequential procedures using different endoscopes, adding time and complexity. The new echoendoscope eliminates the need for multiple instrument exchanges, streamlining the process. This is particularly beneficial for patients with advanced cancer, where minimizing procedure time and potential complications is critical.

Reduced Procedure Time: The simultaneous approach significantly cuts down the overall time required for both duodenal stenting and EUS-HGS.
Enhanced Visualization: The 40° forward viewing direction, combined with a 140° field of view, provides superior visualization compared to conventional oblique-viewing scopes.
Single-Scope Convenience: Eliminating the need for multiple endoscopes simplifies the procedure and reduces patient discomfort.
Improved Stent Placement: Direct visualization of the enteric stricture and stent deployment site enhances the accuracy and effectiveness of the procedure.

In a study involving a 65-year-old man with advanced pancreatic cancer, the forward-oblique view echoendoscope facilitated the successful simultaneous placement of a duodenal stent and EUS-HGS. The total procedure time was just 38 minutes, showcasing the efficiency of this approach. The duodenal stent (Niti-S COM-VI; Taewoong Medical, Gimpo, Korea) was placed under fluoroscopic and endoscopic guidance, followed by EUS-HGS with a long partially covered metal stent (modified GIOBOR, Taewoong Medical) deployed from the B3 intrahepatic duct to the stomach.

Looking Ahead: The Future of GI Endoscopy

The forward-oblique view echoendoscope represents a significant step forward in GI endoscopy, offering a more efficient and effective approach to managing complex conditions. As technology advances, we can expect to see even more innovative tools and techniques that improve patient outcomes and streamline medical procedures. The future of GI endoscopy is bright, with ongoing research and development paving the way for better, faster, and less invasive treatments.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1055/s-0043-116379, Alternate LINK

Title: Simultaneous Duodenal Stenting And Endoscopic Ultrasound-Guided Hepaticogastrostomy Using A Forward-Oblique View Echoendoscope

Subject: Gastroenterology

Journal: Endoscopy

Publisher: Georg Thieme Verlag KG

Authors: Tanyaporn Chantarojanasiri, Hiroyuki Isayama, Yousuke Nakai, Saburo Matsubara, Suguru Mizuno, Hirofumi Kogure, Kazuhiko Koike

Published: 2017-09-05

Everything You Need To Know

What specific conditions are most effectively treated with the forward-oblique view echoendoscope?

The forward-oblique view echoendoscope is particularly effective for patients with advanced pancreatic cancer experiencing a combination of malignant biliary obstruction and gastric outlet obstruction. This device streamlines interventions by allowing for the simultaneous placement of duodenal stents and endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), addressing these complex conditions more efficiently.

How does the forward-oblique view echoendoscope improve upon traditional endoscopic procedures?

The innovative forward-oblique view echoendoscope, specifically the EG-580T from Fujifilm, merges the functionality of forward-viewing and oblique-viewing endoscopes. This design allows for simultaneous procedures, eliminating the need for multiple instrument exchanges that are common in traditional methods. It leads to reduced procedure times, enhanced visualization with its 40° forward viewing direction and 140° field of view, and improved stent placement accuracy. The result is a less complex and more efficient treatment for patients.

What are the key benefits of using a forward-oblique view echoendoscope, as demonstrated in the study?

The key benefits include reduced procedure time, enhanced visualization, single-scope convenience, and improved stent placement. For example, in a study involving a 65-year-old man with advanced pancreatic cancer, the procedure time was significantly reduced to just 38 minutes by using the forward-oblique view echoendoscope. The duodenal stent (Niti-S COM-VI; Taewoong Medical, Gimpo, Korea) was placed under fluoroscopic and endoscopic guidance, followed by EUS-HGS with a long partially covered metal stent (modified GIOBOR, Taewoong Medical) deployed from the B3 intrahepatic duct to the stomach.

Could you explain the components involved in a procedure using this echoendoscope, such as the specific types of stents used?

In the described procedures, two primary types of stents were utilized. First, a duodenal stent (Niti-S COM-VI; Taewoong Medical, Gimpo, Korea) was placed to address gastric outlet obstruction. Second, a long, partially covered metal stent (modified GIOBOR, Taewoong Medical) was deployed from the B3 intrahepatic duct to the stomach during EUS-HGS. The forward-oblique view echoendoscope, such as the EG-580T, facilitates the accurate placement of these stents, ensuring effective drainage and relief of obstructions.

What is the significance of the forward-oblique view echoendoscope in the advancement of GI endoscopy and patient care?

The forward-oblique view echoendoscope represents a significant step forward in GI endoscopy because it offers a more efficient and effective approach to managing complex conditions like those arising from advanced pancreatic cancer. By streamlining procedures and reducing procedure times, this technology potentially improves patient outcomes and reduces the overall invasiveness of treatment. The ongoing research and development in this area promise a future of better, faster, and less invasive treatments for patients with gastrointestinal conditions.