I just wanted to comment, you know, in the motility world, there's also the atmo capsule, which samples the, the, the fluid for bacterial overgrowth and it's going to be a tool for transit time throughout the gut to take place of the, of the motility capsule that we lost. So, that's the only other capsule you didn't mention. Thank you, Dr. Harris. I think we are at the end of our session and but before we go into key takeaways and final thoughts, there's just a few other pending questions that I wanted to make sure that we address. I asked a quick question. Yep. Two things. People wonder when they're starting to decide whether they want to do capsule what system to buy what I mean with all this futuristic stuff happening, I can imagine you buy a system and all of a sudden, there's some intelligence system that you don't have and it's kind of, you know, it's a funny time right now because there's a lot of potential and you're trying to buy what will be compatible with the future, but it sounds to me like all these companies are independently doing, whether artificial or not artificial, intelligence, does anyone want to comment on this for people who are considering getting equipment, you know, like, what do they recommend to their, their practices to do at this point in time. I mean, Carol, Carol brings up a great point, I think most of the, you know, pivoting away from the quote unquote future of capsule industry, it's an excellent point, you know, really, there's so many players in the market now and each of them seems to have very innovative technology, but not one manufacturer necessarily, you know, We're at the end of our session and this is a time for key takeaways. So I thought, as opposed to Paul and me going over the key takeaways, maybe we'll go through each and every one of our panelists as to what would be one takeaway you would share with our attendees today. And then I think after that, Paul, you and I can give some final thoughts. Let's start with Dr. Cave. So I think that for people who are getting into the business at this point in time, we've reached the point of real competition in the industry. So, and there's been quite clearly an enormous markup on these devices and the original company gone through a number of metamorphoses but still has enormous profit margins. Some of the other newer companies are incorporating AI and all sorts of bits and pieces into their systems for the price of the capsule. So look very carefully at the pricing of these different manufacturers. Some of the new ones as well are small. There are risks that they could disappear but at the same time, the alacrity of building in new devices and new bits and pieces is much greater than the big established legacy companies. So I would look around very carefully and look at the pricing plans and what you could get for the same money. And I think in terms of what you're purchasing, they all have about the same resolution. They're all a very high resolution. But the one thing which is only present in one company at the moment is the AI. And that's gonna save everybody a lot of time because the reading times come down from roughly 30, 35 minutes to about a 10th of that. And they're pretty accurate. In fact, the early data out of some of these systems is that they're already better than the human reader. So those are the sort of things you need to look for if you're purchasing a new system. Or a lot of them you don't have to purchase. It can be either a lease or just buy your capsules and everything's included. Great advice. Dr. Harris. Hi, I agree with Dr. Cave. I would take the opportunity when you're at meetings, if you're thinking about doing this, to look at what all the different companies are offering. And if you want to do it, I'm someone who picked it up in the middle of my career. I didn't start out doing it. So I do think that you can also do it you can also pick it up kind of later in your career. You don't have to pick it up as a person out of training. I think I would give that thought. But right now, I still think you do need the time to do it. You need to look at pictures. You need to kind of expose yourself to, you know, all of the images and get an idea so you can recognize things. So I'll give that for all. Thank you, Dr. Harris. Dr. Vemalapalli. I agree with Dr. Cave and Dr. Harris. You know, AI helps with the cutting on the time and also it most likely will accurately diagnose the lesions, but it's still the gastroenterologists, you know, who have to sign off on the report. And so still we should continue to train ourselves, you know, in identifying the lesions and all this stuff before completely relying on the AI, which I think would never happen, hopefully, but that's my advice. Thank you so much. Dr. Kaushal. Not able to, maybe Dr. Samrat. Oh, okay. So what I learned is small bowel endoscopy is here to stay. It's not a flash in the pan like other endoscopic procedures and concoctions we've come up with over the years. And I think thinking and training are still key. I think you're very right that we've sort of lost training in the United States. I don't know how it happened, but there used to be a lot more courses and now they're just almost non-existent. So we need to keep training. Artificial intelligence, of course, you know, it's fine, but I worry about medical legal aspects of that. If you spend five minutes and there's a mislesion, do you blame it on the artificial intelligence who's gonna get sued? I always worry about that. And then I worry about us all being paranoid about that and doing extra work, the AI work and our work. So I, and then I also worry about can artificial intelligence grow their own intelligence or is it fed by our intelligence into the system so it can be intelligent? So what if we don't grow our own intelligence anymore because we stop with artificial intelligence? So I have a lot of circular thoughts about artificial intelligence. I'm not against it. I just realized that I wrote a textbook in the Cecil Textbook of Medicine and I'm sure that's an artificial intelligence, but that was me. That wasn't that machine. And that was all the investigators who came before me synthesizing all that work that then goes into art. So I have, I just, I think it's a good thing for, I agree that artificial intelligence can help things that are very uniform, that's the computers are good at, but I worry about us all stopping thinking about things and doing what's best for patient care and not just kicking the can down the road, so to speak. That's my thoughts, but I am happy that small bowel endoscopy is here to stay and I hope people will get into it and that our training, anyone who has a training program has some capacity to teach this to the younger fellows because that's the only way we're gonna populate more people doing it is by training it because the training fellows are the ones who take innovation forward. The older people stay kind of, we incorporate it to an extent, but the young people really go with it. So I think we still have to have it in our training programs that small bowel capsule and disease be part of it. And then we need people who know how to teach it and train it, so. Absolutely, Dr. Samrat. And I think this is, so maybe it's like a small drop in that bucket and this course, and I absolutely agree with you. I think when we talk about artificial intelligence, it has to be augmented intelligence, as we say. So it has to augment what we do not necessarily replace our intelligence. And yeah, totally with you about, we wanna continue to be more intelligent as well, just can't rely on those machines and devices. Okay. This is, so Dr. Ghapuri. Okay. Hearing no comments. Dr. Ackerman, did you have any? Yes, sorry, I was trying to unmute. My apologies. Yeah, I mean, not to beat a dead drum, I would echo everything my colleagues have said already. I think, you know, I would, yeah, you know, I would go back to kind of some of the comments I made at the end of my presentation regarding, you know, being vigilant for what's out there and making a decision for a platform that makes sense for your practice and, you know, your practice dynamics. You know, this is a rapidly evolving, rapidly changing field, as, you know, my talk briefly touched on. And I think, you know, some people may not need all the capabilities that I touched on. Some may need a few of them. Some may, and I think clearly there's gonna be price stratification and contract stratification based on these offerings. So I think you need to figure out what your needs are and then find a platform that works, you know, based on those specific needs for your institution department division. Great advice. Thank you so much. Thank you. Dr. Ackerman. Thank you very much. I had just a couple of comments, you know, first of all, just let me say thank you to all the participants here, the people who attended and most of all to our esteemed lecturers. I will tell you that the day here for me has been turned out even better than I had hoped. And it's not because of the organization that we put into it, but it was in the content of the material which belongs totally to the presenters. It was really amazing today. We had a real tour de force from the origins of it to the future of it, to the present, to the trials, the tribulations, the how to deal with things that go wrong, how to make things better. And I think that if more trainees are heard this day, they would be excited about this area of expertise within gastroenterology. It's really an exciting place to be. And there's a lot of technology that's gonna really bring it even more to the forefront to make it more enjoyable and fun. I would encourage everyone who's out there who does read capsule endoscopy to think about and encourage them to really become an interventional enteroscopist. I think it adds a lot of if you read it, you should do it to quote Carol. And you're the best one to implement the therapy because you've had the reading and more than just the final output, you have some context to it. So I think you can oftentimes deliver the best care. If you need more training in the single balloon, double balloon, or even spiral, spiral still exists. If you wanna come visit me, I can train you for the day and you can still order some spiral over tubes. So anyway, I encourage people to really delve into this. The future's bright. AI is going to really make this even a more pleasant place to be and more exciting place to be. So that's a few comments that I have. Shivana. Yeah, thank you so much. So I really don't have much more to add. I will say though, if I've missed any questions in the chat or Q&A, I will go through those and make sure that I get back to you if you can send an email. And yeah, I wanna thank our speakers from the bottom of my heart. I mean, incredible talks. Thank you for sharing all your valuable insights. I think this has been an excellent course. Also wanna extend my thanks to Michael Dillertree and Eric. Thank you for being there and supporting us. And Michael, also thank you for keeping us all straight, making sure we get all our talks and everything in. And I think ASG for hosting this wonderful course. And I think our attendees, I think there's been wonderful engagement, excellent questions. And I think we've learned in addition to kind of teaching today, really taking away a lot. Thank you. Have a wonderful day, everyone. Thank you. Very good to see you.

motility tools

gut health

AI integration

capsule endoscopy

diagnostic skills

interventional enteroscopy