The Use of Biomaterials in Gastrointestinal Endoscopy

Gastrointestinal endoscopy has evolved to become a therapeutic resource for multiple pathologic conditions, utilizing many techniques, tools and materials from the field of conventional surgery. Thermal, mechanical or chemical modalities are often employed to expedite the process of hemostasis and achieve a stable coagulum. Thermocoagulation coupled with devices for mechanical hemostasis have been adapted successfully to endoscopy. Chemical hemostasis from biomaterials can be obtained from biologically active materials such as thrombin and fibrin, absorbable products such as gelatins, collagen and oxidized cellulose or synthetic products and inorganic powders. Aside from hemostatic properties, biomaterials are also appealing due to its ability to promote wound healing. However, the use of biomaterials has not been as widespread in endoscopy as in conventional surgery, mainly because of the constraint of delivering these materials through an endoscope. Over the last decade, the options for biomaterials have expanded and its incorporation in endoscopy has slowly increased. Although the cost of biomaterials is higher compared to traditional hemostatics, this may be offset by the potential benefits of decreased bleeding related complications, procedure time, hospital stay and blood transfusions. Biomaterials have demonstrated an improvement in clinical outcomes during conventional surgery. Nevertheless, more studies are required to extrapolate these benefits to endoscopy.