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Archive August 2017 XVIII, No. 8

Improve Your Polyp Detection Rates

Advances in flexible endoscopy enhance your ability to visualize the colon's walls and peer behind its folds.

Dan O

Dan O'Connor, Editor-in-Chief


colonoscopy screening SIGHT UNSEEN The quality of a colonoscopy screening is directly related to how well physicians can visualize the colon's walls and peer behind its folds.

Up to 40% of adenomas are missed during standard colonoscopy. You can blame some of those missed polyps on inadequate bowel preparation and a hasty endoscope withdrawal that doesn't allow time for a careful inspection of the mucosa. The rest? The colonoscope's inability to visualize the colon's walls and peer behind its folds. Fortunately, the latest advances in scope technology are designed to enhance visualization and improve polyp detection rates. High-resolution and high-definition endoscopes and monitors might be tops on that list.

narrow-band imaging

"Narrow-band imaging helps us distinguish between neoplastic and innocuous polyps."

— Stephen Lloyd, MD, PhD

"We have had several patients with flat polyps or discrete tissue changes that would not have been detected without the use of high-definition equipment," says Robert C. LaCava, RN, the clinical administrator of the Advanced Surgery Center in Rockville, Md., adding that HD has enhanced the polyp detection rate by providing a clearer image and letting the physician discover abnormalities in what otherwise may appear to be normal tissue.

"Improved magnification and light-filtering systems included in the HD packaging aid in the detection by allowing the scope to be closer to the mucosa, eliminating the glare that plagued standard-definition models," says Mr. LaCava.

Today's newer scopes are also more ergonomically friendly for the physician — they weigh less and the working channels are larger, while the outside diameters are the same dimension or even smaller, adds Mr. LaCava. "The ergonomic changes also make the scopes more flexible," he says, "allowing for easier and safer cecal retroflection, terminal ileum intubation and detecting polyps from behind folds."

The Lakeland (Fla.) Surgical & Diagnostic Center recently replaced its entire fleet of 37 scopes with high-def colonoscopes and endoscopes. A testament to the amazingly sharp images is the many pictures that physicians now take and show to patients at the bedside. "They explain to patients what they found during the exam and give them a copy of the picture to take home," says Lakeland CEO Emily Duncan, RN, BS, CASC, CNOR.

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