The use of smaller diameter gastroscopes often comes at the expense of functionality which may limit their use in anatomically challenging situations.

A new slim therapeutic channel gastroscope (Fujifilm EG-840TP) with expanded flexibility was recently introduced. The scope was principally designed to support the growing field of third space endoscopy. In this case series, we highlight the diverse applications for this remarkably agile and slim 7.9mm diameter gastroscope with large 3.2mm working channel. This single-center case series performed at a tertiary cancer center highlights seven patients with malignancy who underwent endoscopy with the slim scope for various indications.

We included seven patients who underwent endoscopic interventions using the slim therapeutic gastroscope for various conditions. The diagnoses included metastatic gastric and pancreatic cancer with gastric outlet and distal bile duct obstruction, metastatic gallbladder carcinoma with large bowel obstruction, squamous cell cancer of the tongue with esophageal stenosis and chronic non-healing gastro-cutaneous fistula, recurrent laryngeal cancer with high-grade pharyngoesophageal anastomotic stricture, metastatic gastric cancer with gastric outlet obstruction, and a fistulizing pancreatic cystic lesion incidentally found on CT. Endoscopic procedures performed included: ERCP with biliary stent placement and biliary stent exchange in the setting of gastric outlet obstruction; colonic stent placement; closure of gastro-cutaneous fistula using through-the-scope endo-clips; rendezvous balloon dilation of a high grade pharyngoesophageal anastomotic stricture via a gastrostomy tube site; facilitating endoscopic ultrasound-guided gastrojejunostomy in the setting of severe duodenal stricture; and direct endoscopic evaluation of a fistulizing pancreatic head cystic mucinous neoplasm. These diverse applications demonstrate the gastroscope’s flexibility in managing a variety of complex gastrointestinal oncologic conditions.

Summary of cases highlighting applications for a new slim therapeutic channel gastroscope.

The Fujifilm EG-840TP slim treatment gastroscope has significant advantages when compared to standard and therapeutic gastroscopes due to its small 7.9mm outer diameter, large 3.2mm working channel and expanded flexibility. These cases highlight the versatility and utility of the slim therapeutic gastroscope in navigating anatomically challenging and previously inaccessible locations, offering enhanced therapeutic potential where standard and therapeutic endoscopes may fall short.