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SpyGlass Direct Visualization System: A Cost-Effective Approach Enhancing Nutritional and Immune Recovery in
Kyung In Shin1, Galam Leem2, Jungchul Koo2
1Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Yonsei Medical Journal
|May 27, 2026
Summary
The SpyGlass DS II Direct Visualization System (SpyDS) offers comparable success to percutaneous transhepatic cholangioscopy (PTCS) for difficult bile duct stones. SpyDS significantly reduces hospital stay and shows promising recovery trends, suggesting it as a practical alternative.
Area of Science:
- Gastroenterology and Hepatology
- Minimally Invasive Surgery
- Medical Device Technology
Background:
- Difficult bile duct stones (DBDSs) pose a clinical challenge, often requiring invasive procedures.
- Percutaneous transhepatic cholangioscopy (PTCS) is an established method for DBDS management.
- The SpyGlass DS II Direct Visualization System (SpyDS) has emerged as a potential alternative to PTCS.
Purpose of the Study:
- To compare the clinical outcomes, costs, and post-procedural recovery between SpyDS and PTCS for DBDS management.
- To evaluate the technical success rates and total hospital costs.
- To assess secondary endpoints including length of stay, adverse events, and recovery markers.
Main Methods:
- A prospective interventional study comparing SpyDS-guided lithotripsy (n=20) with historical PTCS-guided lithotripsy (n=23) for DBDSs.
- Primary endpoints included technical success and total hospital cost.
- Secondary endpoints focused on hospitalization duration, procedure costs, adverse events, and recovery indicators.
Main Results:
- Technical success rates were high for both groups (SpyDS: 95.0%, PTCS: 100%).
- The SpyDS group experienced significantly shorter hospital stays (6.5 vs. 21.0 days, p<0.001).
- SpyDS demonstrated more favorable recovery patterns, including better nutritional status and less muscle loss.
Conclusions:
- SpyDS provides comparable technical success to PTCS for difficult bile duct stones.
- SpyDS is associated with a significantly shorter hospitalization period and improved early recovery.
- SpyDS presents a practical and potentially advantageous alternative for managing difficult bile duct stones.
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