Evolving techniques in colonoscopy

Krishna C. Vemulapalli, Douglas K. Rex

Research output: Contribution to journalReview article

15 Scopus citations

Abstract

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 (US)
Pages (from-to)430-438
Number of pages9
JournalCurrent Opinion in Gastroenterology
Volume27
Issue number5
DOIs
StatePublished - Sep 1 2011

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Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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