Episode Transcript
This podcast has been paid for by Olympus Corporation of the Americas.
The views and experiences shared are those of Dr. Davinderbir Pannu from McLeod Regional
Medical Center, a paid consultant of Olympus Corporation and its affiliates. Olympus Amanda
Call is an employee of Olympus. Her statements are her own and are independent of Olympus.
Olympus makes no representations regarding the accuracy or applicability of the content and
disclaims all liability arising from its use. Product performance may vary and techniques,
instruments, and clinical decisions are unique to each facility and practitioner. Always refer to
the instructions for use and applicable labeling for guidance, risks and cautions.
Hey everybody, this is Tom Salemi of DeviceTalks. Welcome back to the
OlympusTalks podcast. We’ve got a great conversation coming your way and I’m happy to be
joined by Amanda Call. Amanda is a clinical endoscopy specialist at Olympus. Amanda, welcome
to OlympusTalks.
Thanks Tom. Thanks for having me.
Today we just had a really great conversation with Dr. Davinderbir Pannu,
who is a very, very, very busy practitioner down in South Carolina. We’re going to get into that
and how the Olympus devices help him get through his day and help him help patients. What
was some of the highlights of the conversation that you had today? What were some of the
things that you’ we were able to cover?
One of the things I really appreciated about today’s conversation with
Dr. Pannu is really how he uses those complimenting technologies from an Olympus device
perspective with his Olympus scopes to treat his patients, especially in the EVIS XI™ 1500 [EZ1500] series
scopes with EDOF™ [technology]. I really appreciated his passion and what he shares that he does to give best
practice care for his patients that he’s treating.
That’s great. And we were able to get both into his background and your
background a bit in the podcast. But one thing we didn’t unpack really is your relationship with
Dr. Pannu. I understand you’ve worked with him for some time.
Yes, just this week when I visited Lawrence we were reminiscing that he’d
been here for at least the last eight years. It’s hard to believe. You kind of think pre-Covid
everything was like two years ago, not blinking to think it was like six, seven years ago now. But
yes, we’ve gone back several different times, a few different capital and device installs. We
have built a nice relationship working together over the last eight years that he’s been in the
Florence, South Carolina area.
It’s been great to get to support him and his patients and his staff.
You two sure showed a great comfort and familiarity with each other. I
think your relationship was shining throughout the podcast, so I know folks will enjoy this
conversation. In this episode of the OlympusTalks podcast, let’s get it going. We’re going to be
talking with Dr. Davinderbir Pannu and, of course, Amanda Call, who is the clinical endoscopy
specialist at Olympus.
Welcome to OlympusTalks, the podcast that brings you to the forefront of
medical technologies as we explore advancements in innovations in GI. This eight episode series
features talks with healthcare professionals, patients and Olympus subject matter experts.
Listen as they dive into various aspects of GI health focused on improving patient outcomes
through best practices. Stay tuned for conversations designed to educate, inspire and inform.
Dr. Davinderbir Pannu and Amanda Call welcome to the podcast.
Thank you.
Thank you Tom for having us.
Our pleasure. It’s always great to delve into the great technologies on
OlympusTalks. So we’re going to be talking about the EVIS X1 [Endoscopy System] and EDOF [technology] a little later in the
podcast. But first, we always love to learn about who we’re talking to and how they got into
MedTech. Dr. Pannu, first for you. How did you find your way into into medicine?
Yes, I growing up. I grew up in a household of physicians. My mom
was an ENT surgeon, father was an ophthalmologist back in India. So I saw them help a lot of
people and that really motivated me to go into medicine to help people. And during my
residency years I found gastroenterology very interesting. It was a good mix between medicine
and procedures and that is what drove me towards this field. And then I further specialized in
advanced endoscopy procedures. Currently, I practice in Florence, South Carolina, where we do
a fair volume of both general GI screening exams as well as complex endoscopy, including third
space endoscopy.
That’s great. And we’re fortunate to have you. I know you’ve got a busy
practice down there. We were working hard to find some time to get this conversation. So
thanks for for taking a moment. And Amanda Call. How did you find your way to Olympus, but
first, what was your first path into medicine?
So I’ve been with Olympus for 13 years. Prior to that I was a registered
nurse. I still hold my nursing license in the state of South Carolina, but I practiced in a couple
different intensive care units in the Indiana market. And then I found my way ERCP lab at IU
Health in Indianapolis and found a new first love of nursing in the endoscopy world. And I was
fortunate to have a very good clinical specialist at Olympus that worked with me when I was in
the Endo unit there. And then this opportunity came available to come to the South Carolina
market and join Olympus as a clinical specialist, primarily focusing on the advanced therapeutic
side with ERCP and EUS, but further with the technologies that has allowed me to do
procedures in the third space world and as well as some of the general GI procedures working
with Dr. Pannu. And so I’ve got to know that team very well during my tenure and that’s how I
got from the nursing side to the medical device industry side.
That’s fantastic. And do you, do you like the transition? Do you talk to
folks on the nursing side about. About the move? Anyone ever want to follow your path?
Yes, that’s a good question. There’s a lot of people that want to follow
the path. I do get a chance to make a lot of good friends and provide opportunities for people if
other vendors are looking or other industry jobs are searching or within even Olympus, I do
have the chance to share that. So it’s a little bit different world not having a home unit traveling
a fair amount. So you get to make a lot of new friends, a lot of different places. But it’s been
nice.
That’s great. Well, you were at a great spot. My son is a Boilermaker, so
Indiana has become sort of a second home for us. So glad you got to spend some time there.
So, Amanda, let’s delve into some of the products we’re going to cover today. One of them I
know is the EVIS X1 [Endoscopy System]. It’s a lighting technology system that you launched two years ago. Can you
talk a bit about what problem did the EVIS XI [Endoscopy System]? What was it created to solve? Where does it fit
into the workplace of Dr. Pannu and others?
Yes, EVIS X1 [Endoscopy System], as you mentioned, was launched two years ago and that’s
our newest technology with some key features and benefits that our older technology did not
offer. For example, we’ll talk about TXI™ [technology] today, which is a technology that uses color, texture and
brightness, and it optimizes those to give a very nice image. RDI™ [technology] is another technology I’m sure
we’ll talk about as well. And that is what is known as our red dichromatic imaging. We’re really
good at Olympus to use three initials for everything. I think everyone knows what we’re talking
about and that uses our red, green and amber wavelengths. The amber is the newest one for us XI
and that allows the light to penetrate deeper and see bleeding points of interest and bleeding
cases or areas that would interest you to address what could potentially be a possibly bleed
during that procedure as those third space cases Dr. Pannu talked about.
And then EDOF™ technology, the E-D-O-F, that’s our extended depth of field
view. And this is the newest one that’s come out to us in just this last September of 2025. And
what it nicely does is it takes the beam of light and splits it so that you end up with a near and a
far image that’s then merged together to give you one very nice optimized image to be able to see that entire image in a much better plane.
That’s great. One of the other nice technologies that the [EVIS] X1™ [EZ1500] series scopes have allowed EVIS X1 [scopes] have given us is what’s known as a magnification power. And it’s been increased with the [EVIS] X1™ series. That does create a more detailed observation being that in our older generation scopes, when, when you got close to the mucosa, you would get a little bit blurry and you’d have to turn a near focus a near image on. In the the [EVIS] X1 [EZ1500] series, as you get, you can actually get much closer than prior and it doesn’t blurry that out. You do have a much crisper image in the [EVIS] X1 [EZ1500] series compared to our 190 series scopes. That’s great. Dr. Pannu, can you kind of zoom out a bit for us and just explain some of the challenges that face gastroenterologists and others who are trying to capture the images they need to effectively treat patients? What are some of the bigger picture, bigger problems that you’re enduring every day and that products like the the EVIS [X1 endoscopy system] help
clear up?
I think the biggest challenge and goal for a gastroenterologist is
that if you are performing screening exams, how can you prevent colon cancer? How can you
detect more polyps? And this has been researched in great detail where adenoma detection
rates have been studied. And improving your adenoma detection rate can help with detecting
more polyps in your screening exams as well as prevent colon cancer downstream.
So any technology focused towards helping us detect more polyps
having a more clear exam, better image quality is very, very helpful. I’ve used the [EVIS] X1 [endoscopy system] platform for about a year now, initially with 190 series endoscopes. And even with that, just the processor helping us create a clearer image with the TXI [technology] function, helping with the contrast, the
brightness helps greatly in detecting the borders of the polyp, smaller lesions, and even outside of screening exams, any case of inflammatory bowel disease or inflammation, the blood vessels
the surface vessels are far more pronounced and more clear to visualize with the newer processor. And I think it has really helped us in providing better quality of care for our patient. What is the experience like for you as you’re looking at different images? Just, I know from myself, zooming in, zooming out. There’s different. This is blurry. That’s
blurry. You kind of need moments to sort of adjust. How does that challenge present for you
and how does a product like the EVIS X1 [Endoscopy System] help clear that up?
Yes, when we are doing an exam, the patient is breathing. You
know, your abdominal wall muscles are moving, your scope is going back and forth. You’re not sitting at, you know, one area and just look, focusing on one part of the colon for a long period of. Because things are constantly moving even if you stabilize the scope. So with the EVIS [X1 endoscopy system] platform, having more contrast and color enhancement can really help you capture polyp in
those seconds that you saw a portion of the colon which may move as the patient breathes or as your scope moves.
So that has really helped in detecting more polyps. And I’ve seen that with my own adenoma detection rate going up at least 10% with use of these technologies.
Amanda, what are you hearing from other clinicians as well? I imagine this experience is similar for them in terms of the past problems. And what are you
hearing from them, those who are using the EVIS X1 [Endoscopy System] and clearing that up?
Yes, everyone that I’ve experienced using the EVIS X1 [Endoscopy System] is echoing
Dr. Pannu’s exact same comments. One of the things I’d like to bring, I forgot to mention
earlier, was another piece that we that was changed in this[EVIS] X1 [EZ1500] series [scopes] is our image sensor at the distal tip. Instead of having a CCD chip in years past, we have what’s known as a CMOS chip and that provides a broader range of colors. All the technologies are built to complement each other, to do just like Dr. Pannu said, helping those cases to see what we’re looking at. Right.
We’re at a small. In a tiny lumen in the body.
So that’s amazing. Dr. Pannu, how important is the ability to detect colors
like that? I guess when I think of images like this, everything seems to be in stark white or sort of binary colors. I don’t know how important is that is seeing colors? Precisely.
We have a particular subset of polyps called serrated polyps. These
are seen mostly in the right colonial. They’re quite flat and they are quite easy to miss if you’re
not looking carefully or if there is, if we don’t have a clear picture on our screen. And even this
morning I was noticing that I was using the 1500 series scope with the EDOF technology, and we had several serrated polyps in a patient in the ascending colon. And I really, you know, paused and thought that I could maybe
with older scopes or older technology, I could have missed these polyps. So I definitely think that these image enhancements and change in the improvement in the technology of the processors is going to help us in detecting these polyps that are difficult to identify.
And Dr. Pannu, outside of screening exams, how does the EDOF technology allow you to perform other procedures? What other procedures are possible?
So common procedure that we perform is endoscopic mucosal resection, also known as emr. And a common method of doing this is, especially for lesions in the cecum or the right colon, is what we call as underwater endoscopic mucosal resection, where we will take the air out of the colon and fill it with water, and it stabilizes the scope as well as allows us to do a safe, safe polypectomy. And I started noticing just with the 190 scopes and [EVIS] X1 [endoscopy] system, that the pictures underwater were much more clear.
But with the EDOF scopes or the 1500 scopes, it is even much bigger enhancement in identifying the borders of the polyp. And that has been very, very useful, especially in those cases. Also, I’ve done several third space cases with this technology and scopes, and identification of vessels in the submucosa [is] has easier with the scopes and technology. And most of these cases we want to do a prophylactic coagulation of the vessel, if you can see it before we are trying to cut in the submucosa.
And that is a big advantage using these scopes.
That’s really fascinating. I didn’t know that was done. Well, Dr. Pannu, if
you wouldn’t mind. I mean, obviously you can’t give great details about these things, but I’d love to know how you have used the EDOF system on a particular case or cases. When is it becoming most useful and most helpful?
I think it is very useful in a wide spectrum of clinical scenarios. Two
particular cases on the extreme ends of the clinical spectrum that we can talk about. One is from this morning where I was doing a screening colonoscopy on a healthy patient, and I detected several serrated or flat polyps, which I instantly thought that the improved technology and image quality has helped me detect these it made me pause and think about it. We do lots of colonoscopies every day. And I think to me it was significant that I could identify these polyps.
So that that was a very interesting perspective that I thought to myself. And then the second scenario, a few weeks ago, I did a rectal ESD and rectal cases are more prone to having submucosal bleeding during the procedure because of more
blood vessels [in the] anatomy. In this case, and with the EDOF [technology] enhancement, I was able to really identify blood vessels in the submucosal space, treat them before I run into excessive amount of bleeding. [In] one instance RDI[™ technology] also helped us in identifying arterial bleed and stopping the
bleeding.
So I think from a screening exam to a third space endoscopy, [there’s a] vast
range of clinical cases that it can be very helpful. In the case of the, the serrated polyps, what would have happened previously if, if they go undetected, Is that just something that would have shown up at a future scan five or ten years down the road? Serrated polyps can turn into cancer. And over a period of three to
five years.
Oh, wow.
And it is well known that even the screening guidelines recommend shorter intervals when you, shorter interval colonoscopies when you detect these
polyps. So it is a very important task for us to detect these. So I think if there is technology helps us in improving the detection of these flat polyps, it will significantly make clinical impact going forward.
Well, let’s look a little more at the screening and the benefits of colonoscopy. Amanda, how does the TXI [technology] and the ECV technology, I know you kind of covered them at the start, but could you give a little more detail on them and sort of explain how they are beneficial in this setting and then we can go back to Dr. Pannu and maybe get some more detail on that?
Yes. ECV is our Endocuff vision tool. That’s a device that’s placed on the
tip of the scope and it’s got some fingers. So when the physician does the withdrawal and they’re looking at the colon wall to look for those polyps, it’ll help spread out those colon folds. The colon’s not perfectly smooth, so you’ve got some folds throughout there. And so as they’re able to use the Endocuff and pair it with TXI [technology] to enhance that color, brightness and texture,
they’re able to better see those lesions. And then especially those with the, as it straightens out those folds behind with Endocuff Vision. Dr. Pannu is definitely one who uses both of those technologies in his screening colonoscopies for his patients for better care.
Dr. Pannu, can you add a little more? How do these technologies help in
those, those particular procedures?
Yes. So I again, going back to the goal of the exam is to prevent colon cancer and what can improve our outcomes. And going back to adenoma detection rate. So the image enhancement is electronic augmentation of the picture and Endocuff is mechanical augmentation. And when you combine the two, you can have a really good exam. Also, the fingers of the Endocuff device allows us to anchor behind folds in the right colon. It can assist in polypectomy and allow a better exam overall.
So Amanda, we’re talking a lot about what the changes that were made
sort of inside on the part of the device used inside the body. Can you talk a bit about what changes you’re making for the doctor? Ergonomic changes, any kind of improvements that make their day easier?
Yes. The [EVIS] X1 platform series scopes, the 1500s have what’s known as
ErgoGrip [control section], which provides the physician with a 10% less weight, [than the EVIS EXERA™ III scope control section], allowing their joints to undergo
less stress throughout the day as well as it provides the opportunity for them to access the knobs and buttons. So therefore the ErgoGrip control section] is a feature that I failed to mention earlier. But it is a new one that has been well received by our physicians, not just our male physicians, but especially, especially our female physicians that often have the smaller hands that can be more of a challenge.
Dr. Pannu, can you add some, some more color as to how those
improvements affect your work?
Yes, I definitely notice the change in weight. I am right handed, so the dials of the scope are in my left hand and I feel that the weight is less, they’re easier to move and they’re the toggle switch on the scope. Now you can touch it from either side and it can switch between modes also much easier than before. So I think these are all great ergonomic changes that will help physicians perform better.
Dr. Pannu, what is your, your day like physically in terms of your
movement and your arms? How much never really thought about how much movement you need to do to do what you need to do. What is, what is your, what does your body feel like at the end of a day?
Yes, we are stand spending most of the day and using both hands
and trying to accomplish this, the task at hand. There is significant stress on small joints in the hand, especially the joints that are trying to move the dials on the scope. So any change in dynamics of the dials and decrease in weight is very welcome and helps us with fatigue and ease of use using the scope.
I believe it. All right, well, let’s talk a bit about what other procedures are
possible with this technology. Is there a movement? How can this be used on the upper gastrointestinal system and other areas of the body and in diagnosing other diseases.
So the procedures we’ll often see used in the upper GI tract would be
some of those third space procedures, what we refer to as ESD or endoscopic submucosal dissection, and even POEM, which is peroral endoscopic myotomy. Those would be some procedures specifically I’ve seen used. And then I’ve been with Dr. Pannu for some of those cases as well.
Dr. Pannu, can you add a little color to that?
Yes. Third space endoscopy. These are procedures where we work
in the submucosal space, which is beneath the surface of the colon and between the surface and the muscle wall of the colon. And this is often a space where we find multiple small or large blood vessels. And a key component of the procedure is how we can prevent bleeding or prophylactically treat a blood vessel before we run into major bleeding during the procedure.
And what I have identified with the 1500 scopes is that the identification of submucosal blood vessels is improved, and I am able to identify these vessels,
treat them, and cause less bleeding during my cases than what I would otherwise see.
Well, that’s a great. A new area that you’re able to explore. Are there any
other procedures that we haven’t talked about that you’ve had success using Olympus as Innovators?
Yes, during colonoscopies, especially in cases with inflammatory
bowel disease, where it is very important and sometimes difficult to detect mucosal changes that can lead to cancer in the future. Having improved image quality goes a long distance. We can very clearly delineate the areas of inflammation, sometimes do target biopsies based on those images. And also another area that I’ve seen it useful is in proctitis or including radiation
proctitis, changes in the distal rectum, where we can clearly identify where the abnormal blood vessels are and treat them instead of doing a treatment all throughout the rectum. And these have been very helpful in those situations.
That’s great. That’s a lot of territory to cover. So thank you for giving us
insight on that. So, Dr. Pannu, you’ve got a wide range of choices of scopes to use of the different series. How do you fit all of these different options and choices into your day? How do you know which patients are appropriate for which scopes and how do you sort of communicate that with your team and get ready for your day? Because as we talked about earlier, you’re having incredibly busy days and I’m sure you want them to move smoothly.
So I make these decisions based on several things. The first thing is what is the clinical task we are trying to accomplish. Second is what scopes do we have
available and third is where the endoscopies to be performed in the hospital itself for a screening exam. My go-to scope would be a 1500 scope with the the [EVIS] X1 processor. For therapeutic cases, depending on whether we are doing EST or POEM and where the location is, we may choose between what kind of scope we use and we communicate with the team before the start of the day.
We write what scopes are needed for each patient so that everybody’s on the same page throughout the day. Because as you mentioned there is a vast
choice of endoscopes and colonoscopes that can be used. The third thing that physicians should be aware of is that the EZ1500 scopes will not work with your older processor systems. So for example in our hospital we have a travel cart which we use to do endoscopy on the floor or the ICU or the operating room and we make sure that we take the 190 series scopes because our processors on the tower are the ones prior to [EVIS] X1 [Endoscopy] System.
So that is important to know when you’re coming on board with these scopes and processors and if you have older processors as well how they talk to each
other.
Amazing. Amanda I guess to close out, it must be great for you to be able
to offer so many options to the doctors you’re working with. Is Dr. Pannu’s sort of account, does that, does that resonate with you at all? Does that sound familiar? How do you interact with others in the field and how do you work with them to ensure that they’re able to use all of Olympus’s innovation and to help patients as they do?
So, in the field, I’m lucky enough to get to work with a lot of the advanced therapeutic guys, and what I’ll do is a lot of the safe and effective use of our devices. So I’m on the device side, really more the devices going down the scope. But as a nurse, you get to know the whole package deal. So the scopes come with it. So it’s always helpful to be in those procedures to be able to troubleshoot devices or troubleshoot a light bulb, something going on with the tower, know who to call and what to look at. So I’ve been able to use my experiences not just in Dr. Pannu’s account, but to help train and work with their staff,
education and physician and new physicians, or specifically the nursing staff, usually to get them making sure their equipment is fully functional for that case and answer any questions.
Dr. Pannu’s definitely got a busy unit and so that’s one that I do frequently get to spend time in because their volume is very high compared to some others.
Well, this has been a great conversation. I mean, just the opportunity to
hear how Olympus innovations are really helping doctors and helping patients. We love hearing these stories from the front line. So thank you both for being on the podcast.
Thank you. We appreciate your time as well. It was a great conversation.
Yes, thank you Dr. Pannu. And thank you, Tom, for your time.
All right, well, that is a wrap. Thanks so much for joining us on this episode
of the OlympusTalks podcast. Thanks, of course, to our corporate partner, Olympus for working with us and making this great podcast series. If you’d like to find the other episodes of OlympusTalks, please visit www.olympusamerica.com/podcasts. Of course, we’d also love you to
follow our DeviceTalks Podcast Network, you know, so you don’t miss a future episode of OlympusTalks. Also, connect with DeviceTalks on LinkedIn. Connect with myself, Tom Salemi. I’m editorial director and our managing editor, Kayleen Brown. So we’d love to be part of your future MedTech conversations and help you find additional episodes of OlympusTalks. Well, that’s it, folks. Thanks again for joining us on this episode of the OlympusTalks podcast.
The EVIS X1™ endoscopy system is not designed for cardiac applications. Other combinations of equipment may cause ventricular fibrillation or seriously affect the cardiac function of the patient. Improper use of endoscopes may result in patient injury, infection, bleeding, and/or perforation. Complete indications, contraindications, warnings, and cautions are available in the Instructions for Use (IFU[ST1.1]).
A rare but potential complication when using ENDOCUFF VISION™ device is the detachment of the device during the procedure. Be prepared to retrieve the device if this were to occur. Ensure ENDOCUFF VISION™ device is used only with compatible colonoscopes, that the colonoscope distal tip is in good condition, and that the device is fully seated on the distal tip prior to the application of lubricant to minimize the chance of detachment.
TXI™ and RDI™ technologies are not intended to replace histopathological sampling as a means of diagnosis.
EVIS XI platform and TXI, RDI, and EDOF technologies are trademarks of Olympus Corporation, Olympus America, Inc., and/or their affiliates.
[BS2.1]Results may vary and the techniques, instruments, and settings can vary from facility to facility. The content of this podcast should not be considered as a substitute for carefully reading all applicable labeling, including the Instructions for Use. Please thoroughly review the relevant user manual(s) for instructions, risks, warnings, and cautions. Techniques, instruments, and settings can vary from facility to facility. It is the clinician’s decision and responsibility in each clinical situation to decide which products, modes, medications, applications, and settings to use.
