Mechanical Colonoscopy Detection Devices Better Than Wide-Angle Viewing

For improving mucosal exposure, mechanical devices outperformed optical devices in a meta-analysis.

In a systematic review and meta-analysis, researchers evaluated whether new technology devices improve colonoscopy performance. They identified 45 trials comprising nearly 21,000 patients undergoing colonoscopy with use of 5 different technologies, including 23 trials of Endocuff, 5 of G-Eye, 2 of EndoRings, 12 of FUSE, and 3 of Third Eye.

Improvement in the adenoma detection rate (ADR) could be demonstrated with Endocuff, G-Eye, and FUSE compared with conventional colonoscopy. However, the overall improvement in ADR and polyp detection rate (PDR), as well as the reduction of miss rate in tandem studies, was better with mechanical devices (Endocuff, G-Eye, EndoRings) than with the optical devices (FUSE, Third Eye).

Comment

This study is focused on mucosal exposure tools. It indicates that the fold-flattening and lumen-straightening devices are more effective than wide-angle and retroview devices. This may be in part because image resolution is better with standard colonoscopes than with FUSE or Third Eye, and a good fold-flattening and lumen-straightening device both exposes all the mucosa and allows high-definition imaging. The study did not consider highlighting strategies per se, including high-definition, chromoendoscopy, and electronic chromoendoscopy with the newer brighter illuminations formats, all of which are potentially complementary to mucosal exposure devices.

Reviewing Author

Douglas K. Rex, MD

Disclosures

Consultant/Advisory BoardOlympus Corporation America; Boston Scientific

Speaker’s BureauOlympus

Grant/Research SupportMedtronic; Boston Scientific; Colonary Solutions; Paion Medical; Medivators; Braintree Laboratories

Editorial BoardsWorld Journal of Gastroenterology; The Journal of Clinical Gastroenterology; Techniques in Gastrointestinal Endoscopy; Gastroenterology & Hepatology; Expert Review of Gastroenterology & Hepatology; Medscape Gastroenterology; World Journal of Gastrointestinal Pharmacology and Therapeutics; Annals of Gastroenterology & Hepatology; World Journal of Gastrointestinal Oncology; Comparative Effectiveness Research; Journal of Anesthesia & Clinical Research; Gastroenterology; World Journal of Gastrointestinal Pathophysiology; Gastroenterology Research and Practice; GI & Hepatology News; Gastroenterology Report; Clinical Epidemiology Reviews; JSM Gastroenterology and Hepatology; GI Journal Watch; Austin Journal of Gastroenterology; World Journal of Gastrointestinal Pharmacology & Therapeutics

Leadership Positions in Professional SocietiesAmerican Society for Gastrointestinal Endoscopy (Treasurer); US Multi-Society Task Force (AGA, ACG, ASGE) (Chair)