Colonoscopy attachments for the detection of precancerous lesions during colonoscopy: A review of the literature

Abstract

Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions, it remains an imperfect examination, as it can fail in detecting up to almost one fourth of existing adenomas. Among reasons accounting for such failures, is the inability to meticulously visualize the colonic mucosa located either proximal to haustral folds or anatomic curves, including the hepatic and splenic flexures. In order to overcome these limitations, various colonoscope attachments aiming to improve mucosal visualization have been developed. All of them - transparent cap, Endocuff, Endocuff Vision and Endorings - are simply mounted onto the distal tip of the scope. In this review article, we introduce the rationale of their development, present their mode of action and discuss in detail the effect of their implementation in the detection of lesions during colonoscopy.

High-definition colonoscopy for improving adenoma detection: a systematic review and meta-analysis of randomized controlled studies

“…Currently, HD-WLE is considered the standard of care for endoscopy, and it is used together with numerous other techniques, new scopes, and various novel devices to optimize performance during colonoscopy and its outcomes. 3,27 In this regard, one might refute the principal research question of the current study, because it may refer to an outdated practice. Although the contribution of HD-WLE in meticulous mucosal visualization and endoscopic diagnosis, characterization, and treatment decision making of lesions in the GI tract is of paramount importance by enhancing fine structural and microvascular details, 28,29 its exact impact on adenoma detection is still debatable.…”

Effect of Endocuff use on colonoscopy outcomes: A systematic review and meta-analysis

“…Various advanced technology endoscopes and add-on devices have been implemented in an effort to optimize the quality of colonoscopy by diminishing the procedures’ adenoma miss rate[7]. Endocuff (Arc Medical Design, Leeds, United Kingdom) and its descendant Endocuff-Vision (Norgine Pharmaceuticals Ltd, Uxbridge, United Kingdom) (Figure 1A and B) is a single-use device mounted on the tip of the scope that consists of a cylindrical core with one (Endocuff-Vision) or two (Endocuff) rows of flexible projections[8]. It is the add-on device with the most available literature, so far; still, its impact on ADR remains conflicting with data suggesting equivocal benefit from its use.…”

Transparent cap‐assisted, water‐exchange colonoscopy in previous incomplete difficult colonoscopy patients: A retrospective study

“…TCAC is a transparent cap attached to the tip of the colonoscope, and since 2007, there have been numerous papers reporting its usefulness in improving CIR, cecal intubation time, and adenoma detection rate. 17 Transparent cap provides a better view in angulated colon and facilitates hooking of the tip of colonoscope against the mucosal fold during loop reduction. 18 Transparent cap also helps in luminal orientation by keeping the mucosa away from the lens (Figure 2), and has a better anticipated direction with sharp turns.…”