Colonic distension with balloon colonoscopy versus standard and distal attachment colonoscopy

Adequate colonic distension during colonoscopy is associated with improved detection of precancerous colorectal lesions. G-EYE balloon (SMART Medical Systems, Ra'anana, Israel) and Endocuff Vision (ECV, Olympus America, Center Valley, Penn, USA) are 2 distal attachments that have been shown to improve detection of adenomas. Although G-EYE balloon is believed to function by distending the colon, the extent of distension associated with these devices is unclear.

We sought to compare colonic distension with G-EYE balloon compared with standard colonoscopy and ECV by 2 observers blinded to the purpose of the study. We recorded videos of the withdrawal phase of the colonoscopy and asked the observers to independently score the distension of the colon every 10 seconds during withdrawal. For each observer, we compared the average scores of each technique.

We recorded 31 videos from June 2021 to July 2021 of G-EYE balloon (n = 10), ECV (n = 10), and standard colonoscopy (n = 11). The patient age distribution was similar at 68.4 ± 11.7, 64.1 ± 11.7, and 65.6 ± 9.2 years for the G-EYE, ECV, and standard colonoscopy groups, respectively. For observers 1 and 2, G-EYE balloon had the highest average distension scores with 5.2 ± 2.1 and 5.4 ± 1.8, respectively, followed by standard colonoscopy with 4.5 ± 1.9 and 4.6 ± 1.6, and then by ECV, with the lowest scores at 3.8 ± 1.6 and 3.8 ± 1.5, respectively (P < .001).

G-EYE balloon is associated with greater colonic distension than both standard and ECV colonoscopy. Improved distension may be a mechanism by which G-EYE increases adenoma detection.