Endoscopic practice at the start of the new millennium.

Progress in the practice of clinical gastroenterology has been made possible, in many respects, by advances in gastrointestinal endoscopy. At the start of the new millennium, unprecedented developments in endoscopic technology suggest that even greater achievements in diagnosing and treating gastrointestinal disorders are possible. However, clinically important endoscopic advances are not routinely met with rapid acceptance and utilization by the general endoscopic community. Reasons for this delay include the cost of acquiring new technology, the difficulty in obtaining additional training once one’s clinical practice has become established, and the (at times appropriate) skepticism regarding any new technology. This review focuses on new developments that are likely to change the day-to-day practice of gastroenterology. We begin with an overview of several relevant technologies that form the basis of the studies discussed in later sections, and present a problem-oriented review of several clinical issues for which significant progress has been made over the past few years. We include several topics that, although not directly addressing endoscopic technique, have the potential to impact general endoscopic practice significantly. Esophagogastroduodenoscopy at the Start of the New Millennium