The Spyglass lets your doctor see your biliary duct system, and difficult-to-reach tiny ducts in the pancreas, with a 6,000-pixel fiber-optic probe attached to a tiny camera. It’s a state-of-the-art add-on to endoscopic retrograde cholangiopancreatography (ERCP). Standard ERCP produces only two-dimensional black-and-white pictures. Spyglass produces precise color images that improve what a doctor can diagnose and treat in a single procedure. This helps avoid further testing after standard ERCP. Only select hospitals and imaging centers have Spyglass technology.
If your doctor needs to take a tissue sample (biopsy) to test a possible tumor or lesion, it can be done with even greater accuracy with the Spyglass. If your doctor finds a stone in a duct, such as a gallstone, it can be broken up (fragmented) during the Spyglass procedure. Spyglass can also be used to open a blockage or in a bile duct caused by a tumor, or to place a metal or plastic stent into a duct to prop open a blocked area.

What to Expect

ERCP with Spyglass takes place at a hospital, surgery center or clinic. Beforehand, you’ll be asked to fast for about 8 hours and avoid smoking and taking certain medications. Once at the hospital, your throat will be numbed with a local anesthetic. You may also receive a sedative. 
Next, your doctor puts a flexible tube (endoscope) in your mouth and passes it down your throat and esophagus to your stomach and duodenum to visualize your bile or pancreatic duct. The tube is equipped with a tiny camera fitted with the Spyglass 6,000-pixel fiber-optic probe. It transmits pictures that your doctor watches on a monitor. 
Your doctor will place air/CO2 into your stomach and small intestine through the endoscope, which helps provide better pictures. A thin tube (catheter) will be placed through the endoscope to inject dye to make your ducts more visible on the X-rays. Once your doctor can see blocked areas, tools can be inserted through the endoscope to remove cells for testing, open blockages, remove or break up stones, remove tumors or insert stents.


After the procedure, you’ll rest in a recovery room while the sedation wears off, which can take an hour. You’ll need to arrange a ride home, because you won’t be able to drive yourself. You’ll want to take it easy for the remainder of the day, but you can resume normal activities the next day. Your throat may slightly hurt for a day or two after the Spyglass procedure.

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