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S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M O N T H 2 0 1 4
Additional assistance
Not every advance in colonoscopy visualization arrives through the camera
lens. Some innovations lend an internal hand instead. A pair of mechanical
innovations to the design of standard endoscopes can literally smooth the
way to better screening colonoscopies.
During insertion, the flexible arms on Medivators' EndoCuff Endoscopic
Overtube are folded down against the tip of the scope. As the scope is with-
drawn, however, they umbrella out to flatten folds in the lining of the colon,
making it easier for physicians to inspect both the front and the back sides of
the folds. The single-use device also serves as a stabilizing handbrake, pre-
E N D O S C O P Y
in order to highlight details in the tissue that weren't otherwise visible.
Many observers anticipated that this feature would be in use during every
colonoscopy. While it certainly plays a useful role in select cases, allowing physicians
to see subtle changes in mucosal patterns at the press of a button, it isn't often used
for the full scope withdrawal. Additionally, a Mayo Clinic study published in the
American Journal of Gastroenterology 2 years ago argues that HD narrow-band imag-
ing endoscopy doesn't significantly increase the detection of polyps, adenomas or flat
adenomas, or reduce the miss rate of polyps or adenomas, in comparison with HD
white-light endoscopy (
tinyurl.com/pp5u6cl
).
Scope manufacturer Olympus has added an optical magnification function and
improved the image freezing function in its new 190 series colonoscopes.
Researchers from Indiana University in Indianapolis compared the abilities of the
190 series scopes against the company's earlier line of 180 scopes. In their study,
published in the March 2014 issue of the journal Endoscopy (
tinyurl.com/oyqjlp8
),
the 190 series showed "less image blurring, improved subjective quality of stored
images, and increased … proportion of high confidence endoscopic estimates of
polyp histology, but did not improve accuracy in estimating polyp histology."
— Seth A. Gross, MD, FACG, FASGE
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