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PWE-376 Endocuff-visiontm: impact on colonoscopist performance during screening
  1. ZP Tsiamoulos1,
  2. R Misra1,
  3. K Patel1,
  4. L Bourikas1,
  5. S Thomas-Gibson1,
  6. A Haycock1,
  7. N Suzuki2,
  8. BP Saunders1
  1. 1Wolfson Unit for Endoscopy, St Mark–s Hospital and Academic Institute
  2. 2Wolfson Unit for Endoscopy, St Mark–s Hospital and Avademic Institute, London, UK

Abstract

Introduction Although colonoscopy is considered the optimal procedure for bowel cancer screening, it remains an imperfect tool for cancer prevention, due to missed adenomas and early cancers. The Endocuff is a simple device attached at the end of the colonoscope that opens up the field of view by retracting folds during withdrawal. Little is known regarding the Endocuff’s impact on a colonoscopist’s performance.

Method The aim of this study was to evaluate the impact of the Endocuff-visionTM(ARC Design Ltd, UK) on the quality indicators for each operator. A prospective observational evaluation study was performed from April 2013 to September 2014, divided in three consecutive periods: pre-cuff (no device used), during-cuff (device used) and post-cuff (no device used). Four screening endoscopists (BPS, STG, NS, AH) utilised the Endocuff-visionTMat their own discretion when device was available to them. Quality colonoscopy indicators {(Adenoma Detection Rate (ADR), Mean number of adenomas per procedure (MAP), Caecal intubation time (CIT)} were analysed (t-test two sample assuming equal variances) in equivalent number of procedures. The total number of procedures performed was 399, 133 per period (BPS/26, STG/53, NS/31, AH/23).

Results The mean ADR was 55.13% in the pre-cuff period, 68.98% in the during-cuff period and 61.74% in the post-cuff period. All four operators showed significant improvement in detection when using the device, which resulted in an overall increased ADR of 13.8% (p < 0.05). During the post-cuff period, the detection performance of the three endoscopists declined while maintaining a high detection rate.

The mean MAP was 1.2 in the pre-cuff period, 2.2 in the during-cuff period and 1.55 in the post-cuff period. The mean MAP increased significantly in all four operators at the during-cuff period (83%, p < 0.05). During the post-cuff, 3 endoscopists returned almost to the baseline MAP pre-cuff level.

The mean CIT was 9.66min in the pre-cuff period, 7.5min in the during-cuff period and 9.54min in the post-cuff period. A decrease in mean CIT was featured (22.36%, p < 0.005) to all operators when using the device, returning to about the pre-cuff levels afterwards.

No complications were reported from the use of the Endocuff-vision although it was electively removed in 4 cases with severe sigmoid colon diverticulosis and one case due to anal discomfort.

Conclusion In this study, use of the Endocuff-visionTMimproved overall performance by making colonoscopy a quicker (CIT) and more efficient (MAP/ADR) procedure. Further randomised evaluation of this simple novel device is warranted.

Disclosure of interest None Declared.

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