The practice of endoscopy has been rapidly changing due to new emerging technologies and novel techniques. There has been more focus on colonoscopy training with the development of structured programmes including simulators. Chromoendoscopy and magnification endoscopy have enabled improved diagnosis of small neoplastic lesions and will be important for the success of colorectal cancer screening programmes. The small bowel is now accessible to diagnostic modalities like capsule endoscopy and to therapeutic tools through the double balloon enteroscope. Endoscopic therapy has also become more sophisticated with endoscopic therapy of reflux disease now possible. Excision of large colorectal adenomatous polyps by endoscopic mucosal resection and dissection of submucosal tumours may reduce the need for surgical intervention. The practice of endoscopy has rapidly changed over the past few years. What was once a simple diagnostic procedure made possible by the development of fibre optics has become a speciality in its own right. This article will highlight some aspects of endoscopic practice that have undergone major changes over the past few years and that will shape endoscopy practice in the future.peer-reviewe
