Copyright ©The Author(s) 2018.
World J Gastroenterol. Oct 7, 2018; 24(37): 4243-4253
Published online Oct 7, 2018. doi: 10.3748/wjg.v24.i37.4243
Table 1 Add-on devices’ main characteristics
CapEndocuffEndocuff VisionEndorings
ManufacturerOlympus, Centre Valley, PennsylvaniaArc Medical Leeds, United KingdomNorgine Pharmaceuticals Ltd, Uxbridge, United KingdomEndoAid, Caesarea, Israel
Launched in market1993201120162015
Short descriptionTransparent, single-use distal attachment with side hole for draining of fluidSingle-use, soft, radiopaque, 2 cm long cylindrical sleeve with flexible projections arranged in 2 rows of 8, emerging from gaps on the shaft of the deviceSingle-use, device with single row of 8 flexible 15 mm spikesSingle-use device composed of 2 layers of flexible, soft circular rings, placed on a cylindrical cuff
MaterialThermoplastic elastomerCore: Non-latex, biocompatible polymer; Projections: thermoplastic elastomerLatex free, polypropyleneSilicone
DimensionsOuter diameter ranging from 13.9-16.1 mm according to each type of capFinger projections: proximal 8.15 mm, distal 5mm; core length: 23.8 mm; diameter: 16.1, 16.7, 17.2, and 18.5 mm (hairs folded back) and 32.6, 33.1, 33.6, and 34.8 mm (hairs opened out)Diameter: 16.1, 16.7, 17.2, and 18.5mm (spikes folded back) and 39.07, 39.07, 39.07, and 39.66 mm (spikes opened out)22-50 mm diameter
Mode of actionProtruding cap manipulates and flattens haustral folds to inspect the mucosa on the proximal side of the fold maintaining optimal field of viewHinged projections flatten and spread mucosa and foldsHinged projections flatten and improve visibility behind the colon foldsSequential rings stretches out the folds of the colon during withdrawal for a clear view
Interfere with view of fieldEdge of the hood comes into the vision field of the colonoscope, but lesions can be seen through the transparent wallNo interference of visionNo interference with visionNo interference with vision
Compatible scopesAdult, pediatric: Ten different sizes, to fit all scopesAdult, pediatric: 4 color-coded sizes (purple, orange, green and blue) to fit all scopesAdult, pediatric: 4 color-coded sizes (purple, orange, green and blue) to fit all scopesScope Distal End Diameter [mm]; Adult colonoscope 12.8-14.5 mm; Slim Adult colonoscope 11.5-13.0 mm
AdvantagesResection of wider areas; Suction and insufflation of air unaffectedFolds movement provides a dynamic picture - even the smallest polyps can be identified; Centers the scope in the middle of the lumen preventing sudden slip back and “red-out”; Projections allow traction to avoid sudden slippage around turns and flexures, improving scope’s stability; Helps perform EMRDelivers more tip control without compromising intubation - improving loop management; Early and controlled view of the upstream surface of large folds - no need for repeated intubation; Prevents sudden slip back and red out; Optimizes tip position during therapy and polyp retrievalMaintains position during loop reduction, decreases slippage, anchoring during endoscopic therapy; Maintains identical depth and breadth of scope's viewing field; Minimal resistance on insertion; Easy ileum intubation
DisadvantagesInterfere with the field of viewPetechial marks on colon; Potential dislodgement; Larger model more effective than smaller; Ileum intubation may be difficultPotential dislodgementIleum intubation may be difficult