Advances in gastrointestinal endoscopy and laser therapy; the way ahead.

Modern flexible fibreoptics enable gastroenterologists to visualise and treat many lesions and conditions in the upper gastrointestinal tract and colon. Therapeutic endoscopy is forming a larger proportion of many unit's workload and the newer techniques to stop or prevent rebleeding are the subject of much research and development. Developments in the fields of operative endoscopy, small intestinal endoscopy, and endoscopic ultrasound are also progressing rapidly. The place of video-endoscopy is still to be established but potentially has several advantages over fibreoptic endoscopy. Laser therapy has been well established as a means of treating gastrointestinal haemorrhage from peptic ulcers, and has potential use in the treatment of angiomatous lesions. It is increasingly being used both for palliation and 'cure' of malignancy and neoplasia in the gastrointestinal tract. The use of such lasers depends upon thermal damage, but newer types of non-thermal laser therapy, using pulsed lasers, or dye lasers with prior tumour sensitisation are rapidly going to be applied to the treatment of gastrointestinal disease.