SpyGlass Direct Visualization

What is the SpyGlass Direct Visualization System?

The SpyGlass Direct Visualization System is a single-operator cholangioscope that is used by experienced, skilled physicians to either remove difficult bile duct and/or pancreatic duct stones or evaluate indeterminate strictures within the bile ducts or pancreatic duct.
Cholangioscopy is an advanced endoscopic technique whereby a small-caliber endoscope is advanced through a larger endoscope into the bile duct or pancreatic duct for direct endoscopic visualization of the anatomy and potential pathology. Historically, this procedure was performed with a mother-daughter scope system, requiring two skilled endoscopists. However, several limitations to this platform led to the development of a more user-friendly cholangioscope, SpyGlass. Currently, Springhill Medical Center is the only hospital in the Mobile area to have this technology available for patient care.

Why is SpyGlass Performed?

Occasionally, standard ERCP techniques are limited in the evaluation and treatment of difficult bile duct and pancreatic duct stones and assessment of indeterminate strictures. An indeterminate stricture is a blockage that occurs in either the bile duct or pancreatic duct that may be suspicious for cancer without a definitive tissue diagnosis. Historically, these patients may have undergone an invasive surgical resection without a tissue diagnosis. SpyGlass is also performed for the evaluation and management of common bile duct and pancreatic duct stones.

What are the risks or potential complications of SpyGlass?

The SpyGlass procedure carries similar risks to conventional ERCP. In addition, studies with SpyGlass have demonstrated an increased risk of cholangitis (infection of the bile duct) compared to conventional ERCP. Therefore, antibiotics are often used before and after the procedure to lower the risks of cholangitis. In addition, there are steps that your physician may take during the procedure to lower the risk of cholangitis.