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What Surgeons Want - November 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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threshold is important to promote the discovery of all polyps, particu- larly flat lesions in the right colon that are more likely to be cancer- ous. Based on that threshold, roughly three-fourths of colonoscopies are considered adequate, according to Dr. Johnson. "But that's not good enough," he says. "We should set the goal at 85%, and hopefully that goal is surpassed." There's been a recent push to enhance the detection of adenomas and define colonoscopy quality based on a minimum detection thresh- old, says Dr. Johnson. He says about one-third of missed incident lesions of colon cancer should have been recognized during a colonoscopy screening. "Although there have been advancements in imaging and colono- scope maneuvering, none have surpassed what skilled endoscopists can achieve with conventional high-resolution magnification and white light imaging," says Dr. Johnson. "We don't have to wait for future technological advancements to achieve the improvements we're striving for." Enhanced views of the colon with retrograde imaging or wide views offering an expanded range of visualization have not definitively shown to provide major advantages in terms of outcomes, says Dr. Johnson. "The technology may increase the detection rate of polyps," he explains, "but whether that leads to significant decreases in colon cancer rates is unknown. We have a sizeable potential to make colonoscopy better by making minor improvements made to present- day technology." Dr. Gross says 360-degree high-def colonoscopes, a reusable clip-on device and flexible endoscope system that provide panoramic views of the colon, and overtubes that improve views of the mucosa and enhance control of the colonoscope's tip all have the potential to improve colonoscopy screenings. But are they worth the added cost? 9 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 6

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