In 2016 the first edition of the SAGES Manual Operating through the Endoscope was published. At the time, this represented a review of cutting-edge new technologies that were being introduced within the field of flexible endoscopy. Largely based on applications and data up to 2013, this served as a unique resource for clinicians and researchers to learn about this expanding field.

Since then, there has been a significant expansion of new technologies and procedures within this discipline that have meaningfully changed this entire sub-specialty. In addition, large numbers of high-quality data have emerged that support more heartily the safety and efficacy of these techniques. Major international societies now routinely include hands-on training and scientific content of this field in meetings and educational efforts, and many trainees and practitioners are looking for resources to improve their knowledge and technical skills sets.