Colonoscopy More Efficient With Endocuff

Megan Brooks

October 12, 2018

PHILADELPHIA — Complete mucosal inspection time is shortened and adenoma detection increases when the Olympus Endocuff Vision device is used during colonoscopy, new research shows.

"The adenoma detection rate is the most important marker of colonoscopy quality. With this device, we had a higher detection rate but a shorter withdrawal time, suggesting that with mechanical enhancement, you are more efficient," said Seth Gross, MD, from Tisch Hospital at NYU Langone Health in New York City.

The flexible arms on the device, which is mounted on the distal tip of the colonoscope, enhance mucosal visualization by holding back colonic folds, exposing hidden mucosa. And the device speeds examination of the mucosa between folds.

"This is a unique study in the sense that it is looking to see if improving our efficiency impacts our detection rate," Gross told the audience here at the American College of Gastroenterology 2018 Annual Scientific Meeting.

For their study, Gross and his colleagues assessed 200 people 40 years and younger who were undergoing screening or surveillance colonoscopy. They randomly assigned 101 to colonoscopy with the device and 99 to standard colonoscopy.

There were fewer women in the device group than in the standard group (44% vs 58%), but demographic characteristics were otherwise similar in the two groups, as was bowel preparation quality.

People with polyposis syndrome, Lynch syndrome, inflammatory bowel disease, severe diverticular disease, a previous colon resection or resection of a large colorectal polyp or colon cancer, or a previous incomplete colonoscopy were excluded from the study.

Inspection, or withdrawal, time was, on average, nearly 2 minutes faster in the device group than in the standard group, but there was no loss of detection, Gross reported.

Table. Outcomes With and Without the Endocuff Vision Device
Outcome Endocuff Vision Group Standard Group P Value
Insertion time, min 9.9 11.3 .143
Inspection time, min 6.3 8.2 <.001
Adenoma detection rate, % 61.4 52.5 .206
Adenomas per colonoscopy, n 1.43 1.07 .077
Sessile serrated polyp detection rate, % 19.8 11.1 .90

These findings are "entirely consistent with our research on Endocuff Vision," said Colin Rees, MD, from South Tyneside District Hospital in the United Kingdom, who has studied the device.

"Endocuff Vision undoubtedly improves adenoma detection rate in some settings and appears to allow detection without slowing the procedure," he said. "Endocuff Vision increases detection in populations with high rates of adenomas," such as those with a positive fecal occult blood test result, "and allows the mucosa to be inspected more easily."

"I also think that Endocuff Vision helps endoscopists who are less good at carefully examining the mucosa," Rees told Medscape Medical News.

Not only are you able to see more adenomas and serrated polyps compared with standard colonoscopy, you can actually do it in a shorter amount of time.

"I think this is an encouraging technology" with "really good operating characteristics," said Jordan Karlitz, MD, from Tulane University in New Orleans. "It allows you to pull back folds and see behind folds."

"The key finding from this study is that, not only are you able to see more adenomas and serrated polyps compared with standard colonoscopy, you can actually do it in a shorter amount of time," he told Medscape Medical News.

The study had no specific funding. Gross is a consultant for Olympus Corp, which makes Endocuff Vision. Rees has received research grants from ARC Medical and Olympus Medical. Karlitz has disclosed no relevant financial relationships.

American College of Gastroenterology (ACG) 2018 Annual Scientific Meeting: Oral abstract 37. Presented October 9, 2018.

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