New technologies

Colonoscopy with polypectomy is currently the standard of practice for detecting and removing superficial neoplastic lesions from the colon that may be precursors of colorectal cancer. The technique of colonoscopy is challenging to learn and perform, and may demonstrate a variable and at times suboptimal rate of procedure completion (colonoscope insertion to the level of the cecum) and adenoma (neoplastic polyp) detection rate. In recent years, many alternative but similar techniques have been developed to overcome these issues. Many of them still remain under clinical evaluation even after several years of development and assessment, as they have not yet been accepted into routine practice, whereas others were soon abandoned, even prior to their introduction into clinical practice. Other procedures that provide a complete and thorough examination of the entire large bowel are currently available and have already entered routine clinical practice (computed tomography colonography and magnetic resonance colonography), whereas some are in the early phase of clinical investigation (colon capsule endoscopy), while others are already in use but require standardization (water-aided colonoscopy).