Endocuff Vision Effective in “Real-World” Experience

Endocuff Vision Effective in “Real-World” Experience

Douglas K. Rex, MD, MASGE, reviewing Forbes N, et al. Endosc Int Open 2021 Oct 25.

Endocuff Vision (ECV; Olympus America, Center Valley, Pa) has produced adenoma detection rate (ADR) gains in randomized controlled trials, but it has not received widespread use, primarily because of added procedural cost. However, some endoscopists struggle more than others with passing it through the sigmoid, and everyone occasionally needs to remove the device for difficult sigmoid colons. Further, endoscopists who like to intubate the terminal ileum find it more challenging when using ECV. 

This study involved 15,814 colonoscopies performed by more than 40 endoscopists across 2 time periods, initially with standard colonoscopy and then with ECV. 

ECV uptake was high, with use in 77.6% of cases in the ECV period. Overall ADR increased from 46.7% with standard colonoscopy to 54.6% with ECV, and there was an increase in fecal immunochemical test (FIT)-positive patients (from 59.5% to 66.8%) and non-FIT indications (from 41.5% to 49.5%). Of 32 endoscopists meeting minimum volume thresholds, 28 experienced increased non-FIT ADRs and 24 had increased FIT-positive ADRs. The cecal intubation rate was 98.1% in procedures without ECV use and 98.6% with ECV use, and withdrawal time was significantly shorter with ECV (7.9 vs 8.6 minutes). Overall procedural duration also decreased with ECV.

Douglas K. Rex, MD, FASGE


These data are from a Canadian colorectal cancer screening center widely recognized for embracing quality. In this setting, ECV uptake was high when it was available, and there were significant increases in detection and decreases in both withdrawal time and total procedural time. As we go forward, state-of-the-art detection in colonoscopy is increasingly likely to involve a mucosal exposure tool, such as ECV, plus a highlighting tool, most likely artificial intelligence.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Forbes N, Hilsden RJ, Ruan Y, et al. Endocuff Vision improves adenoma detection rate in a large screening-related cohort. Endosc Int Open 2021;9:E1583-E1592. (https://doi.org/10.1055/a-1533-6183)

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