Bright stages of formation and modern trends in the development of gastroenterological endoscopy in Russia

Gastrointestinal endoscopy has been surgical specialty in our country since its inception in late 1960s and has been developing mainly due to the efforts of surgical clinics and retrained surgeons in close cooperation with Japanese colleagues and companies. The duties of endoscopist (position that was officially approved by USSR Ministry of Health as separate specialty in the early 70s), along with performing planned and emergent gastroscopy, colonoscopy and ERCP, included laparoscopy and bronchoscopy! After the "outbreak" of modern laparoscopic surgery in the early 90s, it gradually passed into hands of surgeons. At the same time, performing bronchoscopy continues to be the responsibility of endoscopists. A strong trend in the last 10-15 years has been the increasingly active involvement of gastroenterologists in diagnostic/screening endoscopic examinations.
Diagnostic procedures are mostly done in ambulatory settings and interventional procedures in clinical settings. It is generally allowed to perform diagnostic procedures in the clinical setting, but not vice versa. Interventional endoscopy is more and more performed in private practice, but it is still not common, or even not allowed, to perform interventional endoscopy in outpatient settings without available surgical department and an operating room ready to use. But another strong tendency of last years is to reduce patients’ length of stay to about a few hours, instead of few days. ERCP, interventional EUS, ESD, STER, POEM are offered almost exclusively in inpatient settings. There were some exceptions for relatively ‘simple’ ERCP or ESD, but anyway these outpatient facilities have strong connection with a surgical department. Specialists from clinic often work in outpatient settings; it is the common practice of the last years.
The interaction with other specialists is organized via consultations in the most difficult cases. Concerning malignant entities and associated interventions, interdisciplinary collaboration is based on specific tumor boards. Sometimes we are working together, for example during rendezvous biliary procedures.
The way for introduction of new interventional methods is similar: initial information; life-courses; dry lab, then (preferably) wet lab; invited expert; own experience, at the beginning preferably under supervision. Our specialists are immensely grateful to Japanese mentors who have done invaluable work in training competent endoscopists. We can safely say that for the most part our specialists are followers of Japanese school of endoscopy.