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The big picture
High-definition resolution and image enhancement technology promise in-depth
detail, but scopes that offer a wider field of view provide the ability to see a
larger span of the colon at one time and could let physicians spot more polyps,
manufacturers argue.
EndoChoice's Fuse Full Spectrum Endoscopy platform has broken ground in
this regard. Its Generation 2 scope incorporates 3 cameras at the tip to present a
330-degree panoramic view on a 4K monitor. While that wide-angle option
requires upgrading your entire system, scopes and control units, the Third Eye
Panoramic Device from Avantis Medical Systems adds side-viewing cameras
and an expanded view to any standard scope through a clip-on accessory.
"Wider-angle scopes are where we are beginning to see a difference. You can
see everything," says Samir Parikh, MD, FACS, FASCRS, of the Riddle Surgical
Center in Media, Pa. "It requires practice, of course, to be able to comprehend 3
images at once," he adds.
This may raise a practical consideration, as Dr. Ginsberg points out. While these
advances deliver a new way of seeing the procedure, he asks "Does their yield jus-
tify the complexity they add to the process? Given the quality of HD imaging,
excellent enhancement of ability can be achieved without them."
He is quick to admit that his skepticism is rooted in a cost-benefit analysis. "If
technology is going to add cost, it has to deliver value. After all, we're not get-
ting paid more for using more equipment."
Clearing the way
"The ability to perform routine retroflexion helps you to see the right side of the
colon," says Dr. Ginsberg. The articulated tip and bending section of Pentax's
RetroView colonoscope accommodates 210 degrees of angulation in order to
look behind the folds of the colon lining.
Single-use accessories that slip over the distal end of the scope serve as help-
ful fingers inside the colon, deflecting and flattening the wrinkles that can con-
