by Kenneth M. Sigman, M.D.
Colonoscopy has proven its worth over the past 40 or more years. It is clearly the best test for screening for colon cancer and detecting and removing pre-cancerous polyps. Multiple longitudinal studies have confirmed that removing these polyps significantly reduces the incidence of colon cancer. Colonoscopes, and their imaging qualities, have improved remarkably over that time to the current high definition images showing very fine detail of the colonic mucosa. Despite these technologic improvements, a significant percentage of lesions are not seen and are missed – even in the best and most careful examiner’s hands – because haustral folds and turns or flexures create blind spots for these lesions.
A newly designed colonoscope has been developed to improve the field of view and remove some of these blind spots. The standard forward viewing colonoscope (FVC) has one lens with a field of view of 140-170 degrees. The new Fuse colonoscope, full spectrum endoscopy (FSE) produced by the Endochoice company, has three lenses that providea 330 degree field of view allowing an image of significantly more of the colonic surface, reducing blind spots. This should translate into more complete exams detecting more pre-cancerous polyps (adenomas) as well as smaller, cancerous lesions that may be missed by the FVC. Studies comparing the two types of colonoscopes have shown a significantly lower adenoma miss rate for FSE when compared to FVC. A recent multicenter randomized study, published in the Lancet, showed an adenoma miss rate of 41% for standard FVC vs 7% for FSE. Although more data is needed, these early results are very promising.
The Fuse FSE has been in commercial production for about a year. Several institutions in the US have adopted this technology. Trinity Medical Center in Birmingham is the only hospital in the state of Alabama to offer this advanced method of colonoscopy.
The gastroenterologists of Birmingham Gastroenterology Associates continue to be on the forefront of technological advances in GI medicine and offer the most advanced care for their patients. Patients can be scheduled for FSE colonoscopy or any other GI testing by contacting Birmingham Gastroenterology Associates at 205-271-8000.