Expanding the view of a standard colonoscope with the Third Eye~ Panoramic^(TM) cap

AIM: To evaluate a new imaging device for colonoscopy that adds two side viewing CMOS lenses, the Third EyePanoramic. cap.METHODS: In this prospective observational feasibility study, 33 patients, 18 male and 15 female, underwent routine screening, surveillance or diagnostic colonoscopy with the new Third EyePanoramic. cap clipped on to the distal tip of a high definition Fuji EC530-LS Slim Colonoscope. All procedures were performed at the New York Presbyterian-Queens Endoscopy unit by two experienced endoscopists(Rubin M and Kim SH). Main outcome measurements included evaluation of the image quality of the Third EyePanoramic. cap, adenoma detection rate, cecal intubation rate, withdrawal time and total procedure time.RESULTS: The Third EyePanoramic. cap enabled enhanced views without affecting the quality of the colonoscope's image or its handling characteristics through the colon. Ileal intubation was accomplished in most cases, but was more challenging. The side view lenses detected polyps and diverticula hidden behind folds and in flexures not seen on the standard view.The side view lenses were easily cleaned utilizing an EndogatorIrrigation Pump(Medivators, Minneapolis,MN, United States) by angling the scope tip against the mucosa while washing. The cecum was reached in all33 patients. Mean cecal intubation time was 8.19 ± 2.17 min, mean withdrawal time was 10.15 ± 5.56 min and mean total procedure time was 20.31 ± 5.14 min. The overall adenoma detection rate was 44%.CONCLUSION: The Third EyePanoramic. cap enables wide view colonoscopy with enhanced visualization utilizing standard forward view colonoscopes.

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

AIM: To determine the test characteristics of community based video capsule endoscopy (VCE) in patients undergoing sequential VCE and double balloon enteroscopy (DBE). METHODS: Eighty-nine patients (34 females, 55 males, mean age 66) who underwent both VCE and DBE from 2008-2010 were retrospectively reviewed. Lesions detected at VCE were categorized. Capsule directed DBE followed and included 44 antegrade, 11 retrograde and 34 combined antegrade and retrograde procedures. Lesions detected were compared utilizing the McNemar's test. RESULTS: Angioectasia detection with VCE was 25% and with DBE 35% (P < 0.03) with a calculated sensitivity and specificity of 58% and 93% respectively. Polyps were detected by VCE in 22% and in DBE 20%, (P = 0.6), with a sensitivity and specificity for VCE of 61% and 87%. Small bowel diverticula were only seen in 1% of VCE but in 12% of DBE patients (P < 0.002) with a calculated sensitivity and specificity of VCE of 9% and 100%. CONCLUSION: VCE would be moderately sensitiveand specific overall with considerable variation by lesion. Furthermore, VCE cannot be relied upon to diagnose small bowel diverticula.