VIRTUAL REALITY IN GASTROENTEREOLOGÍA AND HEPATOLOGY

It has been reported that endoscopy (fiber optic) and ultrasonography (ultrasound) are "right and left hand Gastroenterologist", but today we are able to say that as the biopsy forceps is the third arm of the endoscopist, the EUS (endoscopic ultrasound) joining both techniques is the third eye of the gastroenterologist. "

Ultrasound is sound and inaudible vibrations of a frequency above 16,000 cycles per second (16 KHz) up to several MHz

At first, using ultrasound is attempted to perform "histograms liver" Transient elastography, until the Fibroscan, which by their hardness measured waves which correlates with liver fibrosis and hepatic steatosis. Non-invasively by a score obtained by sound waves is measured in kPa liver elasticity to reach a plausible diagnosis of hepatic fibrosis or cirrhosis. This is the "virtual liver biopsy." Your only limitations are pregnant or sick patients with implantable medical devices.

The sonoelastography applied to the liver and pancreas, by ultrasound or endoscopic ultrasound, have tried to improve the diagnosis and avoid histological biopsies (FNA versus Virtual biopsy). Is also a non-invasive technique, which can differentiate between inflammation, fibrosis, and cancer using a range of different colors (qualitative) or a scale of 1 to 255 (quantitative) becomes a score (strain ratio).

By miniprobes endoscopy have been used to improve diagnosis, but these have nothing to do with the miniprobe Confoca l which is also introduced by the working channel of the endoscope and is connected to a processor that uses lasers. The more than 30,000 individual optical fibers confer a resolution from 500 to 1000 times greater than the conventional endoscope, in an attempt to study the internal microstructure of the tissue of the digestive system (virtual histology). Is indicated for digestive tract neoplasms, gastritis, celiac disease, colitis, etc.

You can also enter this miniprobe by laparoscopy on the surface of the liver, or by endoscopic ultrasound of the pancreas.

Virtual reality is a science based on computers and other devices whose purpose is to produce an appearance of reality. But is it possible to reach the total reality?

The FibroScan, the sonoelastography, and Confocal miniprobe, noninvasive gastrointestinal , try histological diagnosis in selected areas of the digestive tract , liver or pancreas, try virtual biopsy or differentiation between benign and malignant as important in the diagnosis and treatment.

Many studies are still needed to correlate these techniques with classic biopsies. In some cases, such as fibrosis, inflammation, gastritis, colitis, celiac disease, etc.. Will not be as important overall approximation to reality, but in cases where this is to differentiate between benign and malignant would have to be sure that Reality Virtual correlates exactly with the real reality.