A novel extra-wide-angle–view colonoscope: a simulated pilot study using anatomic colorectal models

BackgroundA major factor that may contribute to a higher adenoma miss rate during colonoscopy is undetected lesions located behind haustral folds, flexures, or rectal valves.ObjectiveTo 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.DesignA 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 MeasurementsThe detection rates of simulated polyps.ResultsThe 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).LimitationsNot a clinical study.ConclusionThe 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.