A novel colonoscope with a wider field of view of 230° – first in human case

During colonoscopy, polyps can be missed, particularly those located behind folds or in tight bends, often due to the limited field of view (FOV) of standard colonoscopes [1] ([Fig. 1]). A recent model-based study evaluating a novel colonoscope with a wider FOV of 230° (PENTAX Medical, Tokyo, Japan) showed a significant improvement in polyp detection compared to standard colonoscopes [2] ([Fig. 2]). The video case highlights its first human use ([Video 1]). The patient, a 69-year-old man with no comorbidities, was scheduled for surveillance after a polypectomy five years ago.

Fig. 1 Different fields of view of an endoscope (not to scale).

Fig. 2 Close-up of the tip of the novel colonoscope.

First human use of novel colonoscope with a wider field of view of 230°.Video 1

The colonoscope was easily advanced into the cecum within three minutes. The wide FOV allowed an unlimited view of the cecum and facilitated the intubation of the terminal ileum ([Fig. 3]). Withdrawal showed a flat lesion at the hepatic flexure. It was characterized as a NICE type 2 lesion after flushing with the integrated waterjet, enhanced imaging, and 1.5-fold electronic magnification. Cold snare resection could be easily performed. Two further small polyps located opposite each other were simultaneously captured in the transverse colon ([Video 1]). Cold snare resection was performed and the specimens were captured by suction. Further withdrawal allowed a complete evaluation of the left colon despite diverticula without major movement of the endoscope tip ([Fig. 4]). The sigmoid was subsequently inspected with a standard colonoscope, suggesting that complete visualization is more challenging due to the smaller FOV. Histology of the resected polyps revealed low grade tubular adenomas.

Fig. 3 View of the cecum and ileocecal valve.

Fig. 4 Complete visualization of the sigmoid circumference.

The case suggests that the new colonoscope is easy to use and facilitates visualization of the entire colorectal circumference. The image quality is excellent. Air insufflation, lens irrigation, and suction quality are comparable to standard colonoscopes. It proves highly effective in the detection and removal of small polyps and flat lesions, including those concealed behind folds.

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Conflict of Interest

Horst Neuhaus has a consultant relationship with PENTAX Europe. The other authors declare no conlicts of interest related to this article.

• References

• 1 Zhao S, Wang S, Pan P. et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta-analysis. Gastroenterology 2019; 156: 1661-1674
• 2 Neuhaus H, Nowak T, Schmidt A. A novel colonoscope with extra-wide field of view optics increases polyp detection rates compared to the standard instrument: Results from a prospective model-based trial. Endoscopy 2024; 56: S22-S23

Publikationsverlauf

Artikel online veröffentlicht:
11. Februar 2025