A Novel Extra-wide-angle-view Colonoscope: a Simulated Pilot Study Using Anatomic Colorectal Models

Background: A major factor that may contribute to a higher adenoma miss rate during colonoscopy is undetected lesions located behind haustral folds, flexures, or rectal valves.

Objective: To assess the efficacy of a prototype, novel, extra-wide-angle-view colonoscope that provides a simultaneous lateral-backward view that complements the forward view lens.

Design: A simulated pilot study of two anatomic colorectal models, each prepared with 8 polyps positioned in obvious locations and 8 polyps placed behind folds. Thirty-two endoscopists with different levels of experience performed examinations on models in a random order by using the extra-wide-angle-view colonoscope and a standard colonoscope.

Main Outcome Measurements: The detection rates of simulated polyps.

Results: The mean detection rate for all simulated polyps with the extra-wide-angle-view colonoscope was significantly higher than that with the standard colonoscope (68% vs 51%; P < .0001). The detection rate for polyps behind folds was significantly higher in the extra-wide-angle-view colonoscope than in the standard colonoscope (61.7% vs 46.9%; P = .0009).

Limitations: Not a clinical study.

Conclusion: The novel, extra-wide-angle-view colonoscope may represent an advancement in colorectal polyp detection. The value of the colonoscope for clinical use awaits further study.