Is Endocuff Vision As Good As the Original Endocuff?
Douglas K. Rex, MD, MASGE, reviewing Aziz M, et al. Endosc Int Open 2021 Jan 1.
The original Endocuff (EC) had two rows of fingers, whereas the currently marketed Endocuff Vision (ECV) has a single row of longer fingers. Although EC and ECV might be expected to work the same, they have not been directly compared. A meta-analysis identified 6 randomized controlled trials for each device in which only high-definition colonoscopes were used.
Overall, the results suggest that EC was more effective than ECV, with a relative risk improvement in the adenoma detection rate (ADR) with EC of 1.22 that was statistically significant compared to 1.12 for ECV that trended toward improved ADR but did not reach significance. Though most of the results favored EC with regard to detection, it should be noted that ECV produced a statistically significant increase in the polyp detection rate (1.15), and ECV increased ADRs in endoscopists with previous baseline ADRs below 30% and below 40%. Interestingly, both EC (relative risk [RR], 1.87) and ECV (RR, 2.07) improved sessile serrated lesion detection. ECV also had a lower risk of lacerations and erosions.
Curiously, one of the EC studies and two ECV studies had numerically higher ADRs with no device on the scope.
![d-rex](/wp-content/uploads/d-rex.jpg)
COMMENTIt will probably take head-to-head comparisons of EC and ECV to determine whether these differences are real, as it is not intuitively obvious for users why the original version of the device would be better than the later version. Further, it’s difficult to understand how detection could be numerically better without the device in some studies, which suggests that the study endoscopists did not use the device properly.
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.
CITATION(S)
Aziz M, Haghbin H, Gangwani MK, et al. Efficacy of Endocuff Vision compared to first-generation Endocuff in adenoma detection rate and polyp detection rate in high-definition colonoscopy: a systematic review and network meta-analysis. Endosc Int Open 2021;9:E41-E50. (https://doi.org/10.1055/a-1293-7327)