Use of a mechanical enhancement device during screening colonoscopy improved polyp detection rates and estimated adenoma detection rates in real-world clinical settings, likely due to improved surface area exposure of the colon, according to an analysis of a large healthcare database.
Despite this demonstrable benefit, the uptake of the device (EndoCuff Vision, Olympus) in clinical practice “is low, probably limited by financial barriers for the cost of single-use products,” according to investigator Seth A. Gross, MD, who presented the findings at the 2023 annual meeting of the American College of Gastroenterology (plenary 50).
“Published studies have shown polyp/adenoma miss rates to range from 12% to 24%,” noted Dr. Gross, a professor of medicine and the clinical chief of the Division of Gastroenterology and Hepatology at NYU Grossman School of Medicine, in New York City. “Endoscopists spend a lot of time trying to minimize these miss rates. We order split-dose bowel preps, aim for six minutes or longer withdrawal time, and really focus on improving our inspection techniques. When all those approaches don’t get us to where we want to be, we can use mechanical enhancements, … and we now also have artificial intelligence to improve detection,” he said.