we're trying to get better at finding polyps."
Let's take a look at the latest advances in scope design and comput-
er-aided diagnosis designed to improve your gastroenterologists' abili-
ty to see more polyps — and decrease the incidence of interval colon
cancer.
Scope design
Endoscope manufacturers are doing their part with improving imag-
ing technology that provides wider-angle views of the colon and a
variety of different light sources, such as narrow-band imaging and
light filtering, to enhance the pattern recognition of polyps. Slimmer
scopes with tighter bending angles and smaller distal ends make
scopes easier for physicians to maneuver and make screenings more
comfortable for patients. Side- and backward-viewing scopes provide
360-degree views of the colon and mucosal folds.
Cap devices placed on the distal end of endoscopes flatten folds in
the mucosa and stabilize the scope in the colon to give surgeons bet-
ter views of the wall. The tools are a struggle to use in patients with a
lot of diverticulitis and narrow, angulated sigmoid colons, because
they impede the forward progress of the scope and make maneuver-
ing around sharp turns difficult, says Dr. Karnes. He says cost is also a
concern: The devices run about $20 per case.
Cap devices are most effective along the left side of the transverse
colon, but less effective along the right side, which is wider, adds
David Margolin, MD, FACS, FASCRS, director of colon and rectal sur-
gical research at the Ochsner Clinic Foundation in New Orleans, La.
Dr. Margolin believes some of the newer endoscopes with rear-view-
ing capabilities are cumbersome and aren't yet ready for prime time.
"Does the technology give you a great image? Absolutely," he says.
"But does it fit into routine workflows? Can it be used regularly to
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