A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model

Background Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures.

Objective To compare the diagnostic yield of balloon-Assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model.

Design Prospective, cohort study.

Setting International gastroenterology meeting. Subject A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps").

Interventions Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-Assisted colonoscopy.

Main Outcome Measurements Detection of simulated polyps.

Results The median polyp detection rate for all simulated polyps was significantly higher with balloon-Assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P <.0001). The significantly higher simulated polyp detection rate with balloon-Assisted versus standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P <.0001) and obscured polyps (88.0% vs 25.0%; P <.0001).

Limitations Non-randomized design, use of a colon model, and simulated colon polyps.

Conclusion As compared with standard colonoscopy, balloon-Assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology.