Advances and Opportunities in NIR-II Endoscopy: From Diagnosis to Therapeutic Applications

Endoscopy refers to the minimally invasive optical visualization and examination of internal structures within the body. Its significance lies in diagnosing intraluminal tissue abnormalities and assisting therapeutics, especially in the gastrointestinal tract. However, conventional optical endoscopes are limited by their insufficient penetration depth. Although endoscopic ultrasound achieves deeper penetration of up to 10 cm, it suffers from compromised spatial resolution. Recent advances have expanded the role of endoscopy from basic mucosal visualization to precision diagnostics, therapeutic assistance, and even intelligent, remote-assisted procedures. An emerging modality, second near-infrared window (NIR-II, 1000-1700 nm) endoscopy, offers deep tissue penetration, reduced scattering, and a high signal-to-noise ratio. This review discusses the clinical requirements of endoscopy across screening, diagnostics and therapeutics. It provides a comparative assessment of current methodologies, and a particular focus is placed on discussing the promising developments in NIR-II endoscopy. Furthermore, we investigate the transformative potential of integrating artificial intelligence and fifth-generation wireless networks into endoscopic practice. The continued evolution and clinical translation of these technologies, particularly NIR-II endoscopy, hold the promise to fundamentally enhance precision medicine in gastroenterology.