Modern medicine is awash with technological advance. Though the last three decades have witnessed countless pharmacological successes, the pace of novel drug development has slowed down. Since the dawn of the new century, medicine has embraced technological changes with a resultant increase in implantable devices. Though the attendant physician may feel that medical devices are the remit of the specialist, with the expanding indications for medical implants, it is likely that physicians will encounter unfamiliar devices in routine and emergency clinical practice. Corbett et al highlight such issues within the sphere of endoscopy.1 Using an initial case of nucleus stimulators, the authors describe a successful endoscopic examination using a multidisciplinary approach. The authors indicate that the number of neurological and cardiac devices is rising. The Heart Rhythm network data indicates an increase in cardiac pacing (both basic and complex) and cardiac defibrillators.2 This data has also been corroborated on a European-wide basis.3 With increasing elderly populations observed throughout primary and secondary care, it is likely that the number of medical devices will increase further. The concern with medical devices and endoscopy …