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Significantly more large polyps were found with DS (NZ251; 7.2%) compared with MCS (NZ6,109; 6.0%) (pZ.01). In multivariate analysis, controlling for age, gender, race, ASA class, and site type; patients sedated using DS were more likely to have large polyps detected vs. MCS (OR 1.25, 95% CI 1.09, 1.42). Conclusions: Our study demonstrates that detection of polyps O 9mm may be higher with DS compared to MCS. This finding persisted even after controlling for possible confounders in the dataset. Further prospective studies are needed to confirm this finding.Background: Endoscopic submucosal dissection (ESD) has been developed for en bloc removal of large flat GI tract lesions. However, ESD is more time-consuming and technically challenging than conventional endoscopic mucosal resection (EMR). The main difficulty of ESD is the lack of counter traction on the lesion. In this study, we report the feasibility of combining a novel T-bar tissue anchor and loop anchor to provide counter traction in facilitating ESD. Aim: To evaluate the feasibility of T-bar assisted ESD in a porcine model. Methods: Two prototype endoscopy accessory Abstracts www.giejournal.org Volume 69, No. 5 : 2009 GASTROINTESTINAL ENDOSCOPY AB121

Background Establishing a threshold of bowel cleanliness below which colonoscopies should be repeated at accelerated intervals is important, yet there are no standardized definitions for an “adequate” preparation. Objective To determine if Boston Bowel Preparation Scale (BBPS) scores could serve as a standard definition of adequacy. Design Cross-sectional observational analysis of colonoscopy data from 36 adult gastrointestinal endoscopy practices; prospective survey showing 4 standardized colonoscopy videos with varying degrees of bowel cleanliness. Setting The Clinical Outcomes Research Initiative. Patients Average risk patients attending screening colonoscopy. Main Outcome Measurements Recommended follow-up intervals among normal, average risk screening colonoscopies stratified by BBPS scores. Results We evaluated 2516 normal screening colonoscopies performed by 74 endoscopists. If the BBPS score was ≥2 in all three segments (N=2295), follow-up was recommended in 10 years in 90% of cases. Examinations with total BBPS scores of 3–5 (N= 167) had variable recommendations. 96% of examinations with total BBPS scores of 0–2 (N=26) had recommended follow-up within 1 year. Similar results were noted among 167 participants in a video survey with pre-established BBPS scores. Limitations Retrospective study. Conclusions BBPS scores correlate with endoscopist behavior regarding follow-up intervals for colonoscopy. A total BBPS score ≥ 6 and/or all segment scores ≥ 2 provides a standardized definition of “adequate for 10-year follow-up” whereas total scores ≤2 indicate that a procedure should be repeated within 1 year. Future work should focus on finding consensus for management of examinations with total scores of 3 to 5.