Evolving techniques in colonoscopy

Krishna C. Vemulapalli, Douglas Rex

Research output: Contribution to journalArticle

15 Citations (Scopus)


Purpose of Review: This review summarizes recent clinical studies of colonoscopy technique and new technologies. Recent Findings: Water immersion reduces pain and sedation doses in unsedated and lightly sedated colonoscopy. Cap-fitted colonoscopy makes insertion faster and improves detection of lesions behind folds, but the latter effect is operator-dependent. A single controlled trial showed improved detection with the Third Eye Retroscope, but the two arms of the study were not controlled for withdrawal time. Chromoendoscopy increases detection of diminutive adenomas, but adds time to the colonoscopy procedure. Electronic chromoendoscopy methods (narrow band imaging, Fujinon Intelligent ChromoEndoscopy, i-scan, and autofluorescence) have been either unsuccessful in improving detection or require more study. However, these methods and several other methods (chromoendoscopy with magnification, confocal laser microscopy, and endocytoscopy) allow accurate real time determination of polyp histology. Summary: Water immersion is a clear advance in unsedated colonoscopy. Cap-fitted colonoscopy is a promising method for both practical and effective visualization of the proximal sides of haustral folds. Electronic chromoendoscopy has been largely ineffective at improving polyp detection, but is effective (as are confocal laser microscopy and endocytoscopy) for diagnosis of polyp histology.

Original languageEnglish
Pages (from-to)430-438
Number of pages9
JournalCurrent Opinion in Gastroenterology
Issue number5
StatePublished - Sep 2011


Confocal Microscopy
Narrow Band Imaging


  • advances in colonoscopy
  • cap-fitted colonoscopy
  • real time histology
  • Third Eye Retroscope
  • water immersion

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Evolving techniques in colonoscopy. / Vemulapalli, Krishna C.; Rex, Douglas.

In: Current Opinion in Gastroenterology, Vol. 27, No. 5, 09.2011, p. 430-438.

Research output: Contribution to journalArticle

Vemulapalli, Krishna C. ; Rex, Douglas. / Evolving techniques in colonoscopy. In: Current Opinion in Gastroenterology. 2011 ; Vol. 27, No. 5. pp. 430-438.
title = "Evolving techniques in colonoscopy",
abstract = "Lippincott Williams & Wilkins.",
keywords = "advances in colonoscopy, cap-fitted colonoscopy, real time histology, Third Eye Retroscope, water immersion",
author = "Vemulapalli, {Krishna C.} and Douglas Rex",
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pages = "430--438",
journal = "Current Opinion in Gastroenterology",
issn = "0267-1379",
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