A Novel Colonoscope with an Extra-wide Field of View Increases Polyp Detection Rate Compared with Standard Colonoscope: Prospective Model-based Trial

Colonoscopy, the gold standard for early detection of colorectal cancer, may miss polyps especially those hidden behind folds. This prospective study compared polyp detection and performance of a novel colonoscope with extra-wide field of view (EFOV) of 230 degrees (partially retrograde) to a standard colonoscope (SC, 170 degrees) in a colon model. A 3D printed colon model was used featuring 12 polyps placed throughout different colon segments, with several located on the proximal side of haustral folds. Endoscopists were instructed to identify polyps, first inserting the SC immediately followed by the EFOV device, and to place a snare to simulate a polypectomy. A standardized survey was used to record operator impressions. Twenty-nine experienced endoscopists participated in this study. On average, 5.3 vs 9.6 polyps were detected with the standard and EFOV colonoscopes, respectively ( < 0.001). Five of 29 operators (17.2%) detected all 12 polyps with the EFOV device, whereas no operator detected all polyps with the SC. The success rate for snare placement was 100% for both endoscopes with similar times (mean of 14 vs 15 seconds for SC and EFOV, respectively). EFOV handling and optical performance were rated as equally good or better by all endoscopists. Use of a colonoscope with novel optics significantly improved polyp detection compared with a standard colonoscope in this non-randomized model-based study, with favorable performance and usability ratings for the EFOV instrument. Clinical studies are needed to confirm these encouraging preliminary results.