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.

Keywords: Adenoma detection rate; Adenoma miss rate; Colonoscopy; Cup; Endocuff; Endocuff Vision; Endorings

Core tip: Colonoscopy is the modality of choice for the detection and removal of precancerous lesions. However, almost one fourth of adenomas can be lost during conventional colonoscopy. Their location proximal to the colonic folds or in proximity to anatomic flexures is one of the reasons for this particular detection failure. To overcome this caveat, various single-use devices mounted onto the tip of the scope have been developed. They facilitate lesions’ detection by manipulating and flattening the haustral folds. In this Minireview we present the development of these devices (Cap, Endocuff, Endocuff Vision and Endorings) and their effectiveness in improving detection rates of lesions during colonoscopy.