Mapping global trends and research frontiers in third-space endoscopy: A visual and bibliometric analysis.

Background: Third-space endoscopy (TSE) is a rapidly emerging field in gastrointestinal (GI) medicine that employs techniques such as endoscopic submucosal dissection (ESD), peroral endoscopic myotomy (POEM), and submucosal tunneling endoscopic resection. Despite TSE's expanding clinical applications and minimally invasive advantages of TSE, the global research landscape and collaborative networks that drive its evolution remain poorly defined.

Methods: A comprehensive search of the Web of Science Core Collection (WoSCC) was conducted for publications between 2015 and 2025 using predefined TSE-related keywords. Bibliometric indicators, including publication volume, citation analysis, geographic distribution, institutional and author productivity, and keyword co-occurrence networks, were assessed using VOSviewer and Microsoft Excel.

Results: Of the initial 47,569 records, 6347 met our inclusion criteria. The number of publications per year has increased steadily from 2015 to 2025, indicating an intensification of academic and clinical interest in the TSE. Japan, the United States, and China were identified as the most prolific contributors, with leading institutions such as the Japan National Cancer Center and the Mayo Clinic. Europe has not been able to demonstrate a dominant scientific position in this field, and has lagged behind. "Surgical Endoscopy and Other Interventional Techniques" emerged as the journal with the highest number of articles published in the field of TSE. ESD and peroral endoscopic myotomy (POEM) are dominant research themes.

Conclusion: This bibliometric and visual analysis highlights the expanding role of TSE in modern gastrointestinal endoscopy. This underlines the clinical impact and research momentum. The predominance of Japanese and American institutions points to both geographical clustering of expertise and potential opportunities for wider international participation. Future perspectives should emphasize comparative clinical studies and rigorous long-term outcome studies to confirm the position of TSE as a cornerstone of minimally invasive GI treatment.