Citation: Boese, A.; Wex, C.; Croner, R.; Liehr, U.B.; Wendler, J.J.; Weigt, J.; Walles, T.; Vorwerk, U.; Lohmann, C.H.; Friebe, M.; et al. Endoscopic Imaging Technology Today. Diagnostics 2022, 12, 1262. https://doi.org/10.3390/ diagnostics12051262 Academic Editors: Masataka Kikuyama and Costin Teodor Streba Received: 9 March 2022 Accepted: 16 May 2022 Published: 18 May 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). diagnostics Review Endoscopic Imaging Technology Today Axel Boese 1, * , Cora Wex 2 , Roland Croner 2 , Uwe Bernd Liehr 3 , Johann Jakob Wendler 3 , Jochen Weigt 4 , Thorsten Walles 5 , Ulrich Vorwerk 6 , Christoph Hubertus Lohmann 7 , Michael Friebe 1,8 and Alfredo Illanes 1 1 INKA Health Tech Innovation Lab., Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany; michael.friebe@ovgu.de (M.F.); alfredo.illanes@med.ovgu.de (A.I.) 2 Clinic of General-, Visceral-, Vascular- and Transplant Surgery, University Hospital Magdeburg, 39120 Magdeburg, Germany; cora.wex@med.ovgu.de (C.W.); roland.croner@med.ovgu.de (R.C.) 3 Uro-Oncology, Roboter-Assisted and Focal Therapy, Clinic for Urology, University Hospital Magdeburg, 39120 Magdeburg, Germany; uwe-bernd.liehr@med.ovgu.de (U.B.L.); johann.wendler@med.ovgu.de (J.J.W.) 4 Hepatology, and Infectious Diseases, Clinic of Gastroenterology, University Hospital Magdeburg, 39120 Magdeburg, Germany; jochen.weigt@med.ovgu.de 5 Clinic of Cardiac and Thoracic Surgery, University Hospital Magdeburg, 39120 Magdeburg, Germany; thorsten.walles@med.ovgu.de 6 Clinic of Throat, Nose, and Ear, Head and Neck Surgery, University Hospital Magdeburg, 39120 Magdeburg, Germany; ulrich.vorwerk@med.ovgu.de 7 Department of Orthopedics, University Hospital Magdeburg, 39120 Magdeburg, Germany; christoph.lohmann@med.ovgu.de 8 Department of Measurement and Electronics, AGH University of Science and Technology, 31-503 Kraków, Poland * Correspondence: axel.boese@med.ovgu.de; Tel.: +49-39-1672-8120 Abstract: One of the most applied imaging methods in medicine is endoscopy. A highly specialized image modality has been developed since the first modern endoscope, the “Lichtleiter” of Bozzini was introduced in the early 19th century. Multiple medical disciplines use endoscopy for diagnostics or to visualize and support therapeutic procedures. Therefore, the shapes, functionalities, handling concepts, and the integrated and surrounding technology of endoscopic systems were adapted to meet these dedicated medical application requirements. This survey gives an overview of modern endoscopic technology’s state of the art. Therefore, the portfolio of several manufacturers with commercially available products on the market was screened and summarized. Additionally, some trends for upcoming developments were collected. Keywords: endoscopy; technology; trends; medical technology; endoscope provider; future technolo- gies; artificial intelligence; big data; image analysis; image processing 1. Introduction Endoscopy is the optical inspection of the inner structures of something. In medicine, it describes the procedure of inspection of the inner cavities of the human body. It is a technology with a long tradition beginning already in the antique with rectal speculums. The story of modern endoscopy started in the early 19th century when the light came into the darkness. Bozzini introduced a mirror to reflect the light of a candle directly into the direction of view through the hollow endoscope tube into the body [1]. After that, several groundbreaking inventions turned endoscopy into the most used imaging modality in medicine today. This covers the introduction of mirrors and electric light, endoscopes with lens systems, the first semi-flexible and flexible endoscopes, the combination with camera systems, the integration of cameras into the endoscope, the combination with minimally invasive treatment options, the use of enhancement technologies and, nowadays the introduction of Artificial Intelligence for decision support, to name only a few. Additionally, the basic principle of optical inspection was adapted to a broad field of medical applications, resulting in many distinct designs and functionalities. Modern Diagnostics 2022, 12, 1262. https://doi.org/10.3390/diagnostics12051262 https://www.mdpi.com/journal/diagnostics