title: Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: a prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video).
abstract: BACKGROUND
  Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed.
  
  
  OBJECTIVE
  To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model.
  
  
  METHODS
  Prospective, multicenter.
  
  
  METHODS
  Six endoscopy units (3 in the United States and 3 in Israel).
  
  
  METHODS
  In vitro colon model with simulated colon polyps (n = 21 metallic beads).
  
  
  METHODS
  Detection of simulated colon polyps on colonoscope withdrawal.
  
  
  METHODS
  Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy.
  
  
  RESULTS
  On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0%) right colon, 2.4 ± 0.87 (48.0%) transverse colon, and 5.7 ± 1.5 (51.8%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7% polyp detection rate (P < .001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0%) right colon, 4.0 ± 0.87 (80.0%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3%) left colon (all comparisons, P < .001). Importantly, the ultrawide-viewing mode detected significantly more "hidden" simulated polyps (81.9% vs 31.9%, P < .0001).
  
  
  CONCLUSIONS
  Nonrandomized design, use of a colon model, and "simulated" colon polyps.
  
  
  CONCLUSIONS
  Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.
authors: Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel.
authors: Ian M
authors: IM
authors: Gralnek
authors: David L
authors: DL
authors: Carr-Locke
authors: Ori
authors: O
authors: Segol
authors: Zamir
authors: Z
authors: Halpern
authors: Peter D
authors: PD
authors: Siersema
authors: Alan
authors: A
authors: Sloyer
authors: Jay
authors: J
authors: Fenster
authors: Blair S
authors: BS
authors: Lewis
authors: Erwin
authors: E
authors: Santo
authors: Alain
authors: A
authors: Suissa
authors: Meytal
authors: M
authors: Segev
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003111:Colonic Polyps / Q000175:diagnosis*; D020685:Colonoscopes; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D055096:Optical Devices; D011446:Prospective Studies