Innovations That Transform Care

Sunday, Nov 24 2019

Endoscopy

Danny was just 1 year old when he was diagnosed with a condition that would impact him for the rest of his life.

Eosinophilic esophagitis, or EoE, causes chronic inflammation of the esophagus. The condition is triggered by food allergies and can make it extremely difficult to eat and swallow. When Danny was first diagnosed, he was vomiting multiple times a day — up to 40 times a week — and not gaining any weight.

“It is a serious diagnosis,” says Danny’s mom, Corinne. “And frustrating because, at first, there were so many unknowns.”

Currently, there is no cure for EoE, and patients require lifelong monitoring and frequent invasive tests, often performed under anesthesia.

But that’s all changing, thanks to new medical innovations developed by doctors at Children’s Hospital Colorado. With the support of donors, Dr. Joel Friedlander and Dr. Glenn Furuta have developed less-invasive ways to diagnose and monitor EoE, and their discoveries are already making life easier for kids like Danny.

An Invasive Test to Find the Triggers

“The hardest part of EoE is identifying the triggers,” explains Corinne. “For some kids, it’s just one food that they’re allergic to; for others, it’s four or more.”

Until recently, the only way to figure out which foods cause the EoE reaction was to do an endoscopy of the upper gastrointestinal tract.

Performed under heavy sedation or anesthesia, the procedure entails inserting a tiny camera and biopsy tool down a patient’s throat. Although necessary, the procedure is costly, must be done frequently, and comes with additional risks and time spent at the hospital.

Danny’s family tried their best to only do endoscopy testing when absolutely necessary. Even so, by the time Danny was 2½ years old, he had already been put under anesthesia a dozen times.

“Every time he had to go under, we would just dread it,” says Corinne.

Adults with EoE are typically monitored through nasal endoscopies, which can be done without sedation. Unfortunately, nasal endoscopy imaging tools were always too big for pediatric use — that is, until Dr. Friedlander had a big idea.

Building a Better Endoscopy

As a pediatric gastroenterologist with an inventor’s mind, it’s not surprising that Dr. Friedlander would look for new, better ways to care for his young patients at Children’s Colorado.

“I’m in the operating room with ENTs and pulmonologists every week,” Dr. Friedlander says. “We noticed that we all have different pediatric scopes that are used for different things. Our team realized that we could use a different technique with a pulmonary scope to fulfill our EoE patients’ endoscopy needs. The idea just grew from working together.”

Dr. Friedlander knew he had a great idea, but he needed a lot of support to turn his concept into an brand new device — one that could be brought to market to improve care for children around the world. Fortunately he had help from Children’s Hospital Colorado’s Center for Innovation.

With their support and mentoring, Dr. Friedlander, along with his colleagues Dr. Robin Deterding, Dr. Emily DeBoer and Dr. Jeremy Prager, founded Triple Endoscopy, Inc. in 2017 to manufacture and market the new procedure.

With the new technique, patients first receive a numbing nose spray. Then, they slip on a pair of virtual reality goggles to distract them while a caregiver gently glides a tiny camera and biopsy tool through the nose, into the esophagus.

The procedure takes about eight minutes, dramatically cutting costs. And with no anesthesia, it reduces what was a full day at the hospital down to a one-hour appointment, so children can often return to school the same day. These improvements have made a tremendous difference for kids like Danny.

“It’s been profoundly impactful,” says Corinne. “Now Danny almost looks forward to his endoscopy tests. He can avoid the IV and sedation, and he gets to be an active participant in discovering more about how to manage his EoE.”

Dr. Friedlander’s endoscopy innovation has been validated through patient trials. So far, doctors from more than a dozen other hospitals have traveled to Children’s Colorado to learn the new technique and bring it to their patients. Danny’s family lives in Phoenix, Ariz., and his local care team recently came to Children’s Colorado to be trained on the nasal endoscopy. That means Danny can now take fewer trips to Colorado for testing, which is welcome news for Corinne.

Triple Endoscopy plans to commercially launch its medical device, described as a turn-key system for pediatric nasal endoscopies, by the end of 2020.

“It’s incredible to be a part of this with my team and all that we have learned through the Center for Innovation,” Friedlander says. “We’re making the impossible, possible.”

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