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A Novel Retrograde-Viewing Auxiliary Imaging Device (“Third Eye Retroscope™”) Improves the Detection of Simulated Polyps in Anatomical Models of the Colon

2006; Elsevier BV; Volume: 63; Issue: 5 Linguagem: Inglês

10.1016/j.gie.2006.03.107

1097-6779

George Triadafilopoulos, David C. Watts, Julian P. T. Higgins, Jacques Van Dam,

Colorectal Cancer Screening and Detection

Background/Aims: Colonoscopy is the “gold standard” for detection of polyps and cancers. However, polyps and cancers may be missed during colonoscopy, especially if they are located on the proximal aspect of haustral folds, rectal valves or flexures. This study evaluated a prototype auxiliary imaging device that extends beyond the tip of a colonoscope and provides a continuous retrograde view to detect lesions that may be missed by the forward-viewing colonoscope. Methods: Three anatomical models of the colon were prepared with multiple simulated polyps. 32% of polyps were obvious and 68% were located on the proximal aspect of folds. Six endoscopists examined each model with two methods. Method A used traditional technique with a video colonoscope (Olympus CF-140L). Method B involved an identical colonoscope with the addition of a “Third Eye Retroscope™” retrograde-viewing auxiliary camera (Avantis Medical Systems, Sunnyvale, CA) positioned within its instrument channel. The order of testing was randomized and blinded. Results: Of the 78 “obvious” polyps, 69 (88%) and 70 (90%) were detected by methods A and B, respectively (p > 0.05). In contrast, of the 162 polyps located on the proximal aspect of folds, 20 (12%) and 131 (81%) were detected by methods A and B, respectively (p < 0.001). Conclusions: In simulated testing, the use of a retrograde-viewing auxiliary imaging device in conjunction with a standard colonoscope significantly improves detection rates of simulated polyps. This novel device promises to enhance the diagnostic yield of colonoscopy, particularly for lesions located on the proximal aspect of haustral folds.