Welcome to a quick shot review of the newest tech introduced to the practice of GI endoscopy over the past year. My name is Eden Essex, and I will be the announcer for this session. This session is being recorded and will be available to you in the near future via GI Leap, ASG's online learning platform. By registering for this event, the program automatically has populated your GI Leap account, and in about two weeks, you'll find a recording of this session there. Contact the ASG office if you need assistance accessing your account. Throughout the event, you will be able to submit questions and comments via the Q&A box. The Q&A will be held at the conclusion of this presentation. If you'd like to raise your hand, we'll see if we can open your phone line. We're going to test that out. We're all about innovation here. So with that, I will say it is now my pleasure to introduce our presenter, Dr. Venkat Akshantala. Dr. Akshantala is a gastroenterologist at Johns Hopkins in Baltimore, Maryland, where he also serves as the director of the LEAD Center for Endoscopic Innovations. He is a member of the ASG Innovation Task Force and chair of the Invention and Innovation Special Interest Group. Dr. Akshantala, the audience is yours. Thank you, Eden, for the kind introduction. All right. Good evening, everyone. Thank you for joining this LEAD. And as Eden was mentioning, this will be also recorded and will be available for later. And what we'll be doing today is doing a quick power play. This will be a quick, short review of the newest technology introduced. And these are my disclosures. And my goal here is to review the endoscopy-based devices and softwares approved in the last one year or so. And this is not an exhaustive list. These are only the products that are available or approved in the United States, not elsewhere in the world. And I'm not reviewing any drugs today. And all the content I will be reviewing is courtesy of the product website and the publications. And I want to give a good flavor of interesting technologies that have come out. And I'll be reviewing some endoscopes, softwares, AI-related products, EOS, pancreability products, chemostat products, bariatric enclosure products, ESD products, and so on. And some of the products that I will be reviewing today are from up-seasoned and established entities. And there are also things I will be reviewing from startups. And there are some that might be potentially disruptive and very cool and interesting technologies. So let us take a look about some of the things that we have seen coming out in the last one year. The first section I will be reviewing is endoscopes or endoscope-based technologies. This is Olympus Texture and Color Enhancement Imaging, TXI technology and RDI technologies that has come up. And Olympus calls it EVS-X1. So they have two separate components within this image processing technology. One is TXI and the second is RDI. So TXI emphasizes on the image information. So it uses different algorithms to improve the brightness, the color difference, and the texture analysis. As you can see on the bottom left, this is the white light imaging, the regular imaging. But with TXI technology, we can differentiate and characterize things much better. So Olympus believes that this can be used to better characterize polyps, barrettes, and so on. So we can accurately identify the barrettes tissue and all the dysplastic tissue and other things much better. And the second thing they have released is called the RDI technology. RDI technology expands on the narrowband imaging that Olympus already has, but it uses the longer wavelengths of light, like the green, amber, and red wavelengths to penetrate in the tissue much more deeply. So what Olympus believes is that we can use RDI technology to identify the source of bleeding. For example, as you can see in the white light, you just see red everywhere. That's blood everywhere. But it's hard to know where the blood is coming from unless you have an active bleeding or very large volume bleeding going on. But with RDI technology, Olympus believes that we can differentiate the shallow blood and the deeper blood, suspecting that the deeper blood is where the actual source of bleeding is. And we can potentially identify the source of bleeding better, so we can go and treat that location. So these are the two technologies that came out from Olympus, the TXI technology and the RDI technology. And this is an interesting endoscope, an EO-ENDO. So this is a sedation-free upper endoscopy. And an EO-ENDO is designed for pediatric and adult transoral and transnasal endoscopy. So the key here is that it can be potentially done without anesthesia because it has an outer diameter of 3.5 millimeter, so extra slim endoscope, much smaller than even the slimmer endoscopes like the SXP from Olympus and the SlimScope from Pentax, which is around 5.3, 5.7 millimeter. This is a 3.5 millimeter outer diameter scope. So extremely thin, so it can be passed through the nose much easily. So for pediatric and adult, it can be passed through the nose or through the mouth and does not require anesthesia. There have been clinical studies already done, and in them they have applied some lidocaine jelly and some lubricant, and they were able to get in pretty easily without anesthesia. It has a two millimeter working channel. So some of the instruments, the pediatric instruments can be passed through for biopsies and for some basic evaluation. So it will be very good for basic diagnostic evaluations and can be done at bedside and other locations without anesthesia, very interesting. And it has a four-way deflection capability as a 120 degree field of view. And as you can see, the controller is also a very small setup box. So pretty mobile and can be used for bedside evaluation and other things. So very cool. And this might help us avoid a lot of sedation and procedures that are for simple diagnostic and so on. So it will be interesting to see how this would evolve further, this EvoEndo. And the next endoscopy technology that I will be reviewing is called EndoSound. This is an EUS, EcoEndoscopy EUS. So that is based on a platform using conventional regular endoscope. As many of you might know, EUS is pretty expensive. So EUS, the setup costs around $200,000 to $50,000 or more. And for different companies, the EUS that comes through. Because the EUS scope is expensive, the EUS processor is expensive, and it limits the availability in many settings. So EUS is usually available only in the hospital setting and difficult to expand to ASCs and so on. So what EndoSound has done is, they have developed an attachment, as you can see in this image here. So this is an attachment that you connect to a regular upper scope. So this can be connected to almost any upper endoscope. And this attachment converts the regular endoscope into an EcoEndoscope, into an EUS scope. This has diagnostic abilities and therapeutic abilities, as you can see in this video here. So you can pass through an FNA needle and should be able to get biopsies through it. So it has different control mechanisms that acts like an elevator. So we can position the EUS scope or EUS transducer and the EUS needle into the area of interest. And it has the regular B mode for imaging EUS. And there is a Doppler and very similar to the conventional EUS scopes. So what they claim is that this can be connected to any endoscope. So it will be a very low cost platform. So this can be made available at ASCs and low volume centers also. This has both diagnostic and therapeutic capabilities. So I think this is very interesting because there are not just in the United States, but many countries in the world that do not have EUS routinely. So this will hopefully make EUS more available throughout the country and worldwide as well. So again, very interesting technology and potentially disruptive. The next technology I will be reviewing is cholangioscope and pancreatoscope. So endoscope that goes through the bile duct and into the pancreas duct. So this is called IMAX. So this IMAX from Microtech. So this is very interesting because some of the cholangioscopes that are currently available that does not have a very good bending tip. So it makes it very challenging to go into the duct, especially the pancreas duct or when there is a sharp angulation to the bile duct. But they have made this into a slim scope with a very flexible tip so that can go into the ducts much more easily. And there are two versions of it. There is a 11.5 French version of it, the larger side. And there is a 9.3 French version also, potentially that can be used as a pancreatoscope, the 9.3 French version. And interestingly, they have, even though they have made the scope smaller, the working channel is actually on the bigger side, 2 millimeter. So even with this scope size, they have a 2 millimeter working channel. So we can pass through forceps that are much larger in size. So 1.6 millimeter forceps through a cholangioscope. Currently what is available is around 1 millimeter. So we have a much larger biopsy forceps. So much larger biopsy forceps, meaning we can get much larger tissue biopsies from the bile duct and can get more diagnostic yield because currently the biopsy yields from some of these cholangioscope-based biopsies are much lower because bile duct cancers have this fibrotic nature to it because of the fibrotic nature to it. So when we take biopsies, it's less diagnostic. And this larger channel also allows for multiple different kinds of instruments to go through. So different kinds of snares, baskets, balloons, and so on. So potentially can be used for multiple different interventions in the pancreas duct and in the bile duct. So very interesting and hopefully will make the cholangioscopy and pancreatoscopy much easier. And more different other interventions can be done using these technologies. And next I want to switch gears and go into balloon endoscopy. For many of us, balloon endoscopy might not be the most exciting thing because very often when we do balloon endoscopy, there is so much slippage of the balloon overtube. So when we are trying to pleate the small bowel, as we are trying to advance into the small bowel, the slippage is so much that we keep on falling back. So that makes the procedure very redundant. But this technology, which is an improvement of the overtube that has a balloon to it, will improve the adhesion or the grip to the small bowel. As you can see in this picture here, this overtube balloon has placations. So this increases the surface area and the grip to the small bowel without having to increase the size of the balloon or the pressure in the balloon so as not to damage the small bowel. So this increase in the placations and the area increases the grip to the small bowel by around 200%. So this hopefully will make this balloon endoscopy much more easier so that we can go much deeper into the small bowel and reduce the procedure time and make the procedure more efficient as well. So again, very interesting technology to improve the balloon endoscopy. And the next technology I will be reviewing with you is a double balloon enteroclysis catheter for EUS gastroenterostomy. As many of you might know, so EUS-based gastroenterostomy, such as gastrogygenostomy, has become more and more popular for us to be able to bypass the gastric outlet obstruction or duodenal obstruction issues. So conventionally, a stent is placed for gastric outlet obstruction or duodenal obstruction. But now with EUS gastroenterostomy, where we place a stent between the stomach and the small bowel, it's becoming very popular to bypass the gastric outlet obstruction. But if you look into the literature, some of the most common complications of this gastroenterostomy or gastrogygenostomy is misdeployment of the lumen opposing metal stent, such as axios or other LAM stents. The misdeployment of the stent happens because the small bowel is not often very well distended. Currently, what we do is we just push water or liquid into the small bowel, hoping that it will be distended well, and then place the stent between stomach and small bowel. But due to small bowel peristalsis, the fluid empties very quickly. So as we are trying to place this LAM stent, it often gets misdeployed going into the peritoneum instead of into the small bowel. So what we need is we need the small bowel to be well filled with fluid and the fluid to be retained. So what this group has done is the CHESS medical group has developed something called the Naja gastrointestinal catheter. What this has is 50 millimeter balloons, two of them, and there is 12 centimeter distance between them. So we advance this catheter that has balloons into the small bowel. So we distend the balloons and in between the balloons, the water is filled and the fluid is retained. And this catheter can be advanced through the endoscope. Once we advance the catheter, once the catheter is in position, we exchange the endoscope. So the catheter and the balloons are in position and the small bowel fluid is retained, and it makes it much more easier to place the gastrogygenostomy stent because the small bowel is so distended. It's a big size firm, so we can place the axios or the other lumen opposing metal stents much more safely. So this improves the gastroenterostomy, gastrogygenostomy procedures, makes it much more safer, and hopefully will make more and more endoscopy providers be more comfortable doing these procedures. And again, this is such an important procedure that will make such a big impact on patient care. So hopefully, this will make the gastroenterostomy, gastrogygenostomy procedures much safer. So again, kudos to this group who developed the Nigel gastrointestinal catheter. And again, switching gears. So we have just now reviewed the endoscope devices. Now let's talk about the softwares. So these have been there here for some time now, at least a few months, a couple of years now. So different softwares for colon polyp detection and characterization. And the softwares are constantly evolving, they're learning, and more and more features are being added. So we initially had this CADD and CADDx systems. CADD system for detection of the polyps and CADDx system to characterize the polyp. As you can see, the different images here to detect the helpers in detecting the polyps, helpers in not missing any polyps, and do a thorough colonoscopy for screening. And there is also the CADDx system that helps us in characterize the polyp, identify a true adenoma, try identifying some displaced features and high-risk features in polyps. And there are also features coming up very soon that will help us measure the polyp size more accurately. And these softwares also have these features coming up that can quantify or give an objective bowel prep scoring. And they can also detect how much of the colonic mucosa have we covered during the screening colonoscopy. And again, another objective way to improve the quality of screening colonoscopy so it can measure whether we have done a complete mucosal examination or not. So lots of interesting technologies with regards to CADD, CADDx system, and so on with colonoscopy. And they are continuing to evolve. These have turned into platform technologies where it is one set of box or one platform into which more and more softwares can be added for a diverse variety of procedures. And one such extension is for Barrett's disease. So this software called Veritie, and it claims that it can identify Barrett's disease much better. It can also differentiate between dysplastic and nondysplastic Barrett's. And they also claim that it can also tell us the depth of invasion of Barrett's. So a lot of interesting features with Barrett's disease because very often it is misdiagnosed, mischaracterized, or missed altogether. So it's good to see such softwares that focus on Barrett's disease as well. And more AI-based softwares. So the next is on capsule endoscopy. So as many of us know, capsule endoscopy is often such a tedious procedure because it is such a long set of images we need to review. And this AI system claims to aid in reading the small bowel capsule endoscopy and focus and guide us to see, know where the actual pathologies are, to know where the bleeding is happening. And it will make the procedure or the reading of the capsule endoscopy much more efficient. And some of the earlier studies and the technology claims that it can reduce the mean reading time from 96 minutes or so in the conventional setting to around 5.9 minutes. Pretty significant reduction in the time. And they claim to make the procedure very, very efficient. And it seems to have very good quality in being able to recognize the bleeding sites, but more other characterizations is yet to be determined. But as we see, there is very good expansion of the AI platforms for different forms of endoscopy. And now we will switch to hemostasis products. And one interesting technology that came out is called Puristat from 3D Matrix Medical Technology. So this is a self-assembling peptide designed for hemostasis. It was used elsewhere in other parts of the body and has been tested in a GI setting as well. And it is a self-assembling peptide, as you can see here, very clear gel, and that can be applied on the bleeding site or the polypectomy site from EMR or EST. So it is approved for use for mild and moderate bleeding post-EST, post-EMR, or to prevent post-procedure bleeding in general, and also for primary non-variceal GI bleeding. So GI bleeding from multiple different etiologies that is of non-variceal cause. So again, very interesting. But still yet to see the long-term clinical results of it and the actual hemostasis efficacy. So we need more clinical studies to know more about these technologies. And another hemostasis product called NexPowder. This is from Medtronic. And this is made of hydrophilic biocompatible adhesive material composed of succinic anhydride and oxidized dextran. And this is claimed to form an adhesive gel after making in contact with the water or blood by reversible cross-linking. One interesting aspect of this is that it does not need any carbon dioxide or air compressor, much simpler technology. And some of the challenges that were there with previous generation of products, such as the catheter clogging and such, so the claim would not be there with this product. And so again, there is claim that this will be sticking to the bleeding site for much longer, but more clinical data is obviously required. and again, these are all new technologies. So there is limited clinical data available for these technologies. And next, let us review some products that have been designed or developed for closure. And this is a technology from Boston Scientific. It's called the Mantis Clip. And this is one of the hemostat or closure clips. But what it has that is very interesting is this anchor prongs. As you can see here, the tip of the clip has this anchor prongs that can be used to grip the normal tissue much better. As you can see, you can grip the tissue, close, then open again, and then close, get the other side of the tissue, and close it together. It is rotatable, which is very, very helpful in general when you are using these clips. And it has such nice grip because some of the other conventional clips do not have as much good grip. So as we are trying to approximate the margins, especially when they are slightly far apart, very often the edges of the clip slip off. But with these anchor prongs, there is less slippage of the tissue. So we can grab one side of the tissue, close it, and go to the other side, get the other side of the tissue, close it, and then deploy. And so definitely very interesting to be able to grip the tissue better and close the defect without having to use much more complicated technology such as suturing and so on. And next, something very similar is from Microtech called DatClip. So what DatClip has is a center post that is flanked by two arms that operate independently. As you can see here, the handle mechanism has two separate closing mechanisms. So the two arms can be handled independently. This is indicated for closure of mucosal and submucosal defects that are less than 3 centimeters. And as we can review here, so this center post has two sides of these arms. So we get one arm for one side of the tissue and then pull it back and then grab the other side of the tissue and grip it together. As you can see, both sides can be approximated pretty well. And this goes through 3.8 millimeter, 3.2 millimeter channel minimum. One challenging aspect might be that it is not as rotatable. But again, this has very nice good grip because it has two independent arms that operate separately. And again, will likely help in good closure without having to use a complex suturing mechanism. And talking about suturing mechanism, so this is a new suturing device from Apollo Endosurgery. This is an overstitch SX, single channel endoscope. And as many of you might be familiar, the conventional suturing system requires a double channel scope. A double channel scope might not be available in all different settings and in many countries as well. So this makes it much more easier that it is a single channel endoscope. This is compatible with over 20 different types of endoscopes from different manufacturers. So and this can do a full thickness closure. So again, clips cannot do full thickness closure. So this can do full thickness closure with a single channel endoscope. And this addresses the limitation of the double channel endoscope that historically the suturing systems were requiring. And this is otherwise the suturing mechanism is all very similar. It's only that it can be done through a single channel. So hopefully, again, the suturing system would be much more diversely available with it being compatible with a single channel endoscope. The next I will be reviewing is a very interesting technology. It is an automated suturing. As many of you might know, suturing is often technically challenging in being able to put the right type of sutures in the right directions and making it all more so linear to get a good closure. And even more also challenging in the bariatric setting when we are trying to do a volume reduction. But this system called EndoZip claims to be automated suturing. So what it does is it has this overtube. We go back again. So it has this overtube through which the endoscope goes in. And this overtube has this spiral-like needle mechanism. So this needle mechanism automatically once the tissue is sucked in, so the tissue is suctioned in, and the spiral needle mechanism goes through the tissue. And this is how the tissue is suctioned in. So the tissue is suctioned in through the endoscope. And once the tissue is suctioned in, there is this spiral needle that automatically goes around. And the spiral needle has the suture that follows and can make the suturing much more easier. And like in the conventional suturing system, one has to place so many sutures and try to pull it together and keep on exchanging, which is often technically challenging. But this automated suturing system makes the suturing, especially in the setting of gastroplasty volume reduction procedures, much more easier. So again, very interesting technology that will also make the bariatric endoscopy much simpler and more widely available. And the next I will be also talking is also related to bariatric procedures. This is the allurian gastric balloons. Yes, the gastric balloons have been there for a long time. But they had to be replaced with endoscopy. And they had to be removed with endoscopy. But this capsule endoscopy, I'm sorry, this gastric balloon does not need endoscope. This is a capsule-based gastric balloon. Patient just swallows this balloon, which is in the form of a capsule. So once the capsule reaches the stomach, it is filled up. So once it's filled up, it remains there. After around four weeks, there is a valve-like system. And the valve opens, and all the liquid comes out. And the balloon collapses, and it is pooped out. And it is just excreted out. It does not need endoscopy. So very interesting that this can be done without needing endoscopy for placement or without requiring endoscopy for removal. So again, hopefully, we'll make the gastric balloons less expensive, more available, and less cumbersome to place and remove. So now moving on to an interesting technology with ESD. This is the SureTrack traction system. As many of you who do ESD procedures understand the importance of traction to constantly pull the tissue away from you as you are trying to dissect. But this is often challenging. And very often, one has to rely on gravity and other things. But this makes the traction much more easier. So this is the SureTrack traction system that has a preloaded elastic silicone band that is placed on a primary clip, as you can see on here. And then a secondary clip is used to anchor the other side of this band to the tissue. And this elastic silicone is designed to consistently retract and release the elastic potential energy. And it gives us a dynamic traction. So as the ESD goes, there is a dynamic traction. So the tissue is pulled away from you. So it makes the dissection process and the ESD process much more easier. So again, very simple technology, but very interesting that will make the ESD procedure much more easier. And this is the SureTrack traction system from Microtech. And this is a pretty cool technology from Lyamka Medical. I apologize, this is not from Microtech Endoscopy. This is from Lyamka Medical. This is called the precision needle. And what this has is a motorized mechanism for the fine needle biopsy in EUS. So in conventional biopsies, so one has to push the needle in and go back and forth, back and forth to get the biopsies. But what the Lyamka needle has is a motorized mechanism. As you can see here, you can see the spiral motorized mechanism that goes in and out and will be able to get much nicer cores of tissue, as you can see here. So they claim that one will require much fewer number of passes and is less user dependent with this Lyamka Medical's precision needle. So this is an automated motorized fine needle biopsy needle that has this spiral mechanism of going in and out and does very good pass and good cores of tissue. And there have been early human trials on this already. And they seem to be able to provide good quality tissue, even from the liver biopsies. So again, very interesting technology to make the EUS biopsies much higher yield. So those are all the technologies I had to review today. And thank you, everyone. We will have a discussion and a Q&A. And Eden will be going over some of these details for the next happy hour that we have with the Invention and Innovation Special Interest Group on March 14 at 6.30 PM Eastern time. The topic of this happy hour is understanding the commercial viability of your ideas. Because this is a question that came up very often in our discussions during our SIG meetings. So that how do one assess or understand the commercial potential of ideas? Because everyone has good ideas. But it's very hard to know how commercially viable it is, what is the market of it, and would somebody be interested in investing, and so on. And we will have a special guest for this happy hour. We will have a venture capitalist. And we will also have a CEO who has established several startups in the GI endoscopy world. So look forward to seeing you all during this meeting. Thank you, Dr. Akshantala. What a wonderful presentation. It just tells us that the future is so bright for GI endoscopy and, most importantly, for our patients. So if you wouldn't mind turning on your camera so people can get a look at our leader of our SIG. And I do hope we have more people join our SIG. We'll show you how to do that at the close of this session. We don't have any questions in the question box right now. We do welcome you to raise your hand. And we can open your phone line if you'd like to have a chat. We can only have one person chatting with Dr. Akshantala at a time. But we welcome you to do that. Or you can write something in the Q&A box. And we would be happy to look at it there. So we'll just take a few minutes here. While we're waiting for any questions or hands to be raised, Dr. Akshantala, could you share a little bit more of the venture capitalists and the CEO? Could you share a little bit more like their names and possibly a little bit of their backgrounds as kind of a teaser for people? Sure, Aden. And during some of our previous discussions at the Innovation SIG, and as I was mentioning, this was a common question that came up to understand the commercial viability. So we have invited some individuals who have a lot of experience in the GI startup world. So we have Mike Freeman from Innosphere. So he's a venture capitalist. He has invested on and funded several technologies, even related to endoscopy. Very seasoned venture capitalist, and who has also given several academic presentations and written books and chapters. So he will be coming in and we'll be talking about what does it take for your idea to be interested to a venture capitalist. So what is something that a venture capitalist would be interested in funding? So thinking, for example, thinking about the market potential, thinking about other competing technologies, and thinking about all the risks that one has to take before making that product commercially available. And the second speaker we have is Jeremy Stockweather. So he is a CEO who has established several startup companies in the endoscopy world, and has decades of experience working in the endoscopy world. So he will be talking also about how to translate some of these ideas into successful commercial entities. Wonderful, wonderful. And I think the other thing, when we think about the SIG that's so wonderful is you and Dr. Hoff are talking about creating opportunities for people who are newer to innovation and invention, and then also for seasoned people. So kind of two different tracks too. So we do have a question in the question box. And someone's asked, can you talk a bit about the Fostering Innovation Task Force ASG has formed and the work on a white paper? Absolutely. That's a good question. And the motivation for this has come from some of the leaders in the ASG, from the ASG leadership, Pratik Sharma and Dr. Amitabh Chak. And they were motivated by the lack of innovation in general from endoscopists, compared to some other specialties in medicine. And endoscopy is so rapidly evolving. And we need more and more innovations, not just from industry, not just from engineers, but from endoscopists. Because endoscopists are the people on the ground. So they are the ones who see the patients, who understand the unmet need. And when there is a technology develop, they know exactly how they want the technology to perform, all the features they want in the technology. So when innovations come from endoscopists, there is a different flavor to it. And that is what this is the goal of the Innovation Promotion Task Forces. And many of us do conventional clinical research. But this is to move one step further and convert that research or the development into a commercial entity also. So it talks about the development process of an innovation, and also the commercialization process of an innovation. So this is what the Innovation Task Force is trying to promote. And there are various different activities in it. And one of them is the white paper that we have drafted. It will be published very soon. This white paper talks about everything one has to know, the basics of innovation and commercialization. So it talks about how to think about ideas and how to think about the value proposition of your ideas. So what does this your idea add? So it helps you think about the commercial potential of it again, the market assessment. So to think about the patent process, to think about how to protect your ideas. And it will talk about also on how to get funding for this, how to develop prototypes, how to establish startups, and so on. It gives you the full overview of this innovation and commercialization process. And that, we hope, will help endoscopists and encourage more of them to go into this process. That's tremendous. That will be wonderful. Again, the future is very bright for our patients. We still don't have any questions. If anybody will keep the lines open, or we can close a little bit early tonight. We'll keep the box open. And you could raise your hand as well. We can open a phone line. We'll just hang on here for a minute more and see if anybody has anything else. That certainly was a comprehensive presentation and a tremendous amount of food for thought for people. And this is certainly a dialogue that we are starting and that is going to continue. So we do hope. And if our AV support, Terrence, if you could bring up our final slide just so we can show people how to join the Invention and Innovation SIG, that would be wonderful. And as the slide is being pulled up, so I again want to emphasize on how much the ASG leadership is emphasizing and trying to promote this innovation related activities. So it's a great opportunity for everyone and to spread the word about innovation. And yes, indeed, this is very different and not the convention. But there is a lot of scope and potential and interest in this. So again, those who do endoscopy routinely, so they definitely can benefit from joining these activities and help promoting the innovations. Yeah, so you can see on screen here, folks, if you go into our membership tab, and then you'll see the special interest groups there. And you can download a SIG application. It's just $25 to join for the year. It can become part of your dues moving forward. And it looks like we might have another question, Dr. Akshanpala, if you wouldn't mind turning your camera back on. What would you recommend for an idea that has overlap with a pre-existing device or would offer an improvement on a pre-existing device? It's an interesting question. And again, when there is an existing device, it doesn't mean that another device cannot be developed. As we see with countless different snares, clips, and so on, there are things that are definitely that one can do to improve them further. So the trick is to ensure that whatever one is developing is different enough so that there is an IP, an intellectual property that can be generated, because it's only the IP that will help it move forward. And one can work with an IP attorney and can convert and ensure that whatever their idea is does not infringe upon existing IP and that it is unique enough. And very often, the IPR attorneys will tell you and give you some ideas about how this can be done. And the prototyping engineers will help you to make sure that it is unique enough and translate your idea to improve onto existing devices. And that definitely can be commercialized as well, as you can see, again, with countless different snares, clips, that keep on improving upon existing technologies. And again, it's a good question. Excellent question and response. I think what I'm really taking away from here is this is just the start of our conversation, or even midpoint, because this conversation has been going on. So as we move forward, we encourage folks to become part of the Invention and Innovation Special Interest Group and join Dr. Akshantala and Dr. Hoff, the vice chair of that group. We will meet in March virtually. And then we'll meet again at DDW. There'll be a SIG reception there, so we can all get together and see each other face to face if you happen to be there. But we do plan to hold a lot more SIG virtual happy hours, too. We kind of try to do them at a nice time, maybe around 6 PM Eastern, so that everybody can perhaps have the beverage of their choice and enjoy a nice chat with Dr. Akshantala. So with that, Dr. Akshantala, do you have any final comments? If not, I'll wrap this up. And I echo your words, Eden. And again, there is a lot of interest in this. And we are investing more resources into this. And this is just the beginning, again, to different activities related to the SIG. And welcome you to join, all, and spread the word. Wonderful, wonderful. Thank you, Dr. Akshantala. And to you, our audience, as a reminder, a recording of this session will populate your GILeap account when it is available. Before we sign off, you can kind of take note of our screen here with information on how to join the Invention and Innovation Special Interest Group that is chaired by Dr. Akshantala. With that, this concludes the presentation, providing a quick shot review of the newest tech introduced to the practice of GI endoscopy over the past year. We hope this information is useful to you and your practice.

GI endoscopy

technology review

advanced imaging

AI assistance

hemostasis products

suture devices

ESD procedures

innovation in endoscopy