[China Tech] Shanghai Doctors Invent New Endoscopic Solutions

China Tech is a column dedicated to the innovations reshaping China – and, inevitably, the world. From cutting-edge AI labs and next-generation robotics to apps that redefine daily life, we explore the breakthroughs that emerge from the country's relentless drive for technological dominance. Some are game-changers, others cautionary tales, but all offer a glimpse into the future as it's being built, at breakneck speed, in China.

Patients with duodenal tumors can now be treated via endoscopy to achieve super-minimally invasive outcomes, thanks to an innovative therapeutic approach developed by clinicians at Shanghai's Zhongshan Hospital.

Normally, such patients rely primarily on minimally invasive procedures dominated by laparoscopy.

Now, specialists at Zhongshan Hospital have advanced the duodenal laparoscopy-endoscopy cooperative surgery (LECS) into an enhanced endoscopy-laparoscopy combined surgery (ELCS).

"This represents a revolutionary innovation, as we have transformed the traditional surgical paradigm for digestive disorders," said Zhou Pinghong, director of the endoscopy center at Zhongshan Hospital – the world's largest such center.

"Endoscopy now serves as the primary surgical modality, enabling precise resection of lesions within the digestive tract, while laparoscopy acts as an external standby escort, providing rigorous monitoring and suturing support. This marks the world's first application where endoscopy takes the leading surgical role."

Zhou made the remarks recently at the Shanghai Symposium of Endoscopology and the Sino-Japanese ESD Summit.

"The duodenum features an extremely complex anatomical structure and is widely regarded as a highly surgically challenging site," he explained.

"This innovative technique achieves complete lesion resection while effectively preventing perforation risks, preserving patients' normal anatomical structure and physiological functions. It signifies that the management of complex digestive diseases has evolved from organ resection toward function preservation."

"China has emerged as a global leader in endoscopic treatment. Many international clinical guidelines are drafted by Chinese physicians, and I have traveled abroad to perform surgical demonstrations using China-developed devices, which have been well-received by international clinicians," Zhou noted at the summit, which drew more than 3,500 experts from home and abroad.

"In addition, we can now treat chronic appendicitis using endoscopy, a condition traditionally managed through open or laparoscopic minimally invasive surgery. This advanced endoscopic approach is currently only available in China," he added.

Such breakthroughs, Zhou emphasized, rely not only on surgeons' expertise but also on innovations in medical device development.

"A device jointly developed by researchers from Fudan University and Zhongshan Hospital integrates all essential functions for gastrointestinal endoscopy into a single system," he stated.

Clinicians generally need multiple separate instruments to perform different procedures. This all-in-one device, however, supports marking, cutting, exfoliation, polypectomy and hemostasis in one unit.

"It is the world's first device of its kind and received a top award at the congress of the European Society of Gastrointestinal Endoscopy (ESGE) last year," Zhou revealed.

Opportunity for International Medical Tourism

Endoscopy represents an ideal option for expatriates and international patients traveling to Shanghai for medical tourism, given its high efficiency and affordable pricing.

"In Western countries, patients often face waiting times of six months to a year for endoscopic procedures, whereas in Shanghai, the entire process can be completed in just a few days," Zhou noted.

"Patients undergoing gastroscopy can even receive the examination on the same day if they attend on an empty stomach. For colonoscopy, the waiting period can be as short as two days, allowing sufficient time for necessary bowel preparation."

Costs are also significantly lower than in the West.

Charges for a standard gastroenteroscopy in general departments range from 1,000 yuan (US$146.68) to 3,500 yuan in Shanghai. For treatment at international medical departments, the cost is typically between 10,000 and 20,000.

"These prices are considerably lower than those in Europe, the United States and Hong Kong," Zhou added.

"We are seeing a growing number of expatriate patients or people with commercial insurance for our service each year. We treated over 7,000 patients at the international medical department last year."