Colonoscopy is a commonly performed procedure for the diagnosis and treatment of a wide range of conditions and symptoms, and for the screening and surveillance of colorectal neoplasia.
Many studies demonstrate that colonoscopy offers substantial protection against colorectal cancer (CRC). The effectiveness of colonoscopy in reducing colorectal cancer is influenced by multiple factors, including the quality of the bowel preparation. The following criteria are increasingly used for objective evaluation and feedback:
The efficacy of colonoscopy depends on its ability to detect colorectal neoplasia. In order to maximize the detection power, it is important not only to improve the examination technique and quality of bowel preparation, but also to engage advanced imaging technologies such as High-Definition endoscopy, virtual chromoendoscopy, or add on devices, such as SCOPEPILOT.
An adenoma is a benign "lesion" originating from glands that have a higher potential of development into a malignant lesion. The adenoma detection rate (ADR) refers to the proportion of screened subjects in which at least one adenomatous lesion is identified. ADR has emerged as a major quality indicator in colonoscopy 1. The detection and complete removal of adenomatous lesions reduce the incidence of colon cancer and mortality in screening colonoscopies 2.
HD+ endoscopes with adequate illumination facilitate the detection of suspicious lesions 3, which need to be characterized with the support of enhanced endoscopy, such as i-scan TE and Twin Mode (i-scan study) 4, to decide if they are adenomatous lesions. The endoscope withdrawal in retroversion (RetroView) or the usage of magnification endoscopes (MagniView) increase the detection of potential adenomas 5 behind or between the folds. It also characterizes those flat lesions difficult to be identified as an adenoma.
SCOPEPILOT aims to ensure optimal conditions for an efficient, safe and comfortable procedure. In conjunction with the information provided by the 3D image, it is easier to identify and target small polyps or adenomas during insertion. This may potentially increase the adenoma detection rate.
Caecal intubation is defined as the passage of the colonoscope tip to a point proximal to the ileocecal valve and the visualization of the entire cecum. Caecal intubation rate (CIR) refers to the proportion of complete examinations, adjusted for incomplete examinations owing to very poor bowel preparation or a stricture caused by a tumor 1. As part of European CRC screening recommendations, the caecal intubation rate is globally recognized as the main indicator of competence in colonoscopy, as a poor completion rate may be one reason why colonoscopy does not prevent cancer in the right colon 2.
Today’s colonoscopes are expected to provide a predictable flexibility profile and a balance between flexibility, pushability and torque control. All PENTAX Medical colonoscope insertion tubes are configured with i-FLEX™ and TrueTorque™ technology to overcome the daily challenges of colonoscopy.
Withdrawal time means inspection time in minutes upon withdrawal from the caecal pole to the anus in negative procedures 1. In the case of a negative colonoscopy (i.e. no pathology detected), withdrawal time should take a minimum of 6 minutes 1. Two large studies have supported withdrawal times of 6 minutes or longer and demonstrate a significant variability in adenoma detection amongst experienced colonoscopists and a linear relationship between withdrawal time and adenoma detection rate 2, 3.
TrueTorque™ technology, ensures predictable movement to withdraw the colonoscope efficiently.
The relationship between patient comfort and experience is a commonly used performance indicator for colonoscopy 1. Bowel cancer screening can prevent the development of polyps in cancer, thus, it is extremely important to increase the acceptance of the program. Furthermore, if a patient undergoes a colonoscopy, they should experience a comfortable examination, minimizing the level of apprehension that is connected with the procedure1. Ideally, a colonoscopy should be safe, complete and comfortable. It should also detect and safely and completely remove all significant lesions 1.
The HD+ and high performance colonoscopes series aims to increase patient comfort, offering expanded therapeutic options for the operator with a short bending radius. CO2 insufflators enable a longer duration of colonoscopy and a higher level of patient comfort. The colonoscopists with the highest CIR use less sedation, cause less discomfort and achieve a better patient experience.
An "adverse event" is defined as preventing the completion of the planned procedure (excluding technical failure or poor preparation). Colonoscopic adverse events are unusual, but may be potentially life threatening 1. Perforation is the most serious colonoscopy-related complication in the short term, and can occur during the diagnostic phase of the exam or result from polypectomy. There is no doubt that Quality in Colonoscopy should be associated with a very low complication rate.
The slim RetroView colonoscope enables the performance of interventional endoscopy in retroversion with more comfort and safety. Today’s colonoscopies are expected to provide a predictable flexibility profile together with a balance between flexibility, pushability and torque control. All PENTAX Medical colonoscope insertion tubes are configured with i-FLEX™ and TrueTorque™ technology to overcome the daily challenges of colonoscopy. CO2 insufflators enable longer colonoscopy procedures and potentially reduce the complication rates.