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Rey. Mini-invasive Surg 2021;5:21 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.14

Editorial Open Access

Forward: A new kind of endoscopists for advanced

therapeutic endoscopy

Jean-François Rey
Hepato-Gastroenterology Department, Institut Arnault Tzanck, St. Laurent du Var 06700, France.

Correspondence to: Prof. Jean-Francois Rey, Hepato-Gastroenterology Department, Institut Arnault Tzanck, St. Laurent du Var
06700, France. E-mail: jean-francois.rey@orange.fr

How to cite this article: Rey JF. Forward: A new kind of endoscopists for advanced therapeutic endoscopy. Mini-invasive Surg
2021;5:21. https://dx.doi.org/10.20517/2574-1225.2021.14

Received: 4 Feb 2021 Accepted: 7 Feb 2021 Published: 8 May 2021

Academic Editor: Giulio Belli Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Since the first endoscopic papillotomy carried out by the physician M. Classen in 1993 (München,
Germany, simultaneously with K. Kawai, Kyoto, Japan), numerous non-invasive procedures have been
performed by physicians and surgeons with different backgrounds in the biliary-pancreatography field, as
well as in all parts of digestive endoscopy. In 2007, natural orifice transluminal endoscopic surgery
(NOTES) was more experimental than a promising routine procedure, but it led to the development of
devices for full-thickness resection (FTRD), endoscopic submucosal dissection (ESD), and stenting
procedures to avoid aggressive palliative surgery. Development of therapeutic endoscopic ultrasonography
(EUS) during the last decade has allowed the bile duct access to drainage even when traditional endoscopic
retrograde cholangiopancreatography (EPRC) is impossible due to duodenal obstruction. Depending on
local teaching organization, all of these therapeutic procedures are performed by either physicians or
surgeons. The Chinese Endoscopic Society has proposed the global concept of Endoscopology Society with
a special interest for some advanced procedures including in the area called Super Minimal Invasive Surgery
(SMIS).

This trend leads to the differentiation as well as reunification of various types of endoscopists. They
differentiate when only about 10% of physicians are accredited to perform these very skillful therapeutic
procedures, with the other 90% preforming gastroscopy and colonoscopy Level 1 (dilation, variceal ligation,
polypectomy, etc.). For example, they should not perform ERCP without a very demanding initial training
as well as regular practice. ERCP can be carried out in any endoscopy unit, as was done in the early 1980s,

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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