lens and the additional convex shaped lens combine to form a single
image. A feasibility study suggested potential for a higher adenoma
detection rate (ADR).
• Aer-O-Scope. The Omniview technology of the single-use, self-
propelled pneumatic Aer-O-Scope from GI View combines a 57° for-
ward-viewing lens and a 44° lateral view circular around the entire
central axis.
• The Third Eye Retroscope. This is an auxiliary device with a cam-
era and light source from Avantis. After insertion through the working
channel of a standard colonoscope, it is angulated 180° to allow for an
additional retrograde view of the colon with a resulting significant
increase in adenoma detection of 11% to 23%. To spare the working
channel, the Third Eye Panoramic (Avantis) with 2 side-viewing cameras
and light sources is attached to the tip of a colonoscope. A small feasibil-
ity study reported promising results.
"Narrow-band imaging is helpful in making polyps look different,
but wider-angle scopes is 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."
Other scope systems employ digital image post-processing to pro-
vide the enhanced views. The software that powers Fujifilm's FICE
(Flexible Spectral Imaging Color Enhancement), Pentax's i-SCAN and
EndoChoice's Lumos Adaptive Matrix Imaging analyzes white light
images as they're sent to the video processor and selectively high-
lights specific wavelengths of reflected light and anatomical features.
Flattening folds
Another approach to increase visualization of the colonic mucosa is
to straighten out folds. You can mechanically flatten colonic folds and
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