scopes are a must now, due to their ability to much more clearly dis-
play small polyps. It's far easier for physicians to detect adenomas
thanks to the added detail these vastly improved cameras provide — 5
times the pixel count of standard definition. Analyses show that HD
gives you a 3% to 4% gain in ADR, according to gastroenterologist
Douglas K. Rex, MD, a professor at Indiana University-Purdue
University in Indianapolis, Ind. This enhanced view can be particular-
ly helpful for less experienced examiners. A key point, though: Just
having an HD scope won't help unless your whole system is HD-
enabled, including the processor and the video monitor.
We're starting to see some ultra-high-def 4K scope technology hit
the market, and that even further-enhanced image quality — 4 times
the resolution of HD — certainly can't hurt. But as with HD, all ele-
ments of the video processing chain must be 4K-capable to derive its
benefits.
2. Mechanical scope attachments
Colonoscopes are long, thin and flexible, and not specifically designed
to look behind folds and flexures in the colon wall. That's led to some
inventions that enhance the basic scope design. Mechanical exten-
sions can help scopes explore hard-to-see areas of the colon.
Combining these mucosal exposure devices with an HD scope system
can help improve ADR.
• Cap-assisted. This is as rudimentary as it gets. You're placing a
transparent plastic cap on the distal tip of the colonoscope. The idea
is that the cap will flatten mucosal folds.
• Cuffs and rings. Other options are more elaborate than simple
caps, but are likewise attached to the distal end of colonoscopes. One
is a hard plastic device featuring a single row of hinged, flexible arms.
The other is designed with layers of flexible silicone-rubber rings. The
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