How can Olympus technology contribute to better cost efficiency while improving quality?

Delivering a high-quality examination should not be compromised by cost considerations. However, with rising numbers of procedures, cost efficiency becomes a pressing issue. Olympus endoscopes have been proven to enable time and cost savings.

Cecal insertion time can be reduced by 20% by using colonoscopes featuring Responsive Insertion Technology. They may help to gain time for additional examinations or detailed observation.(37)

By using ScopeGuide and colonoscopes with Responsive Insertion Technology, amounts and costs for sedative drugs can be reduced, contributing to quicker patient recovery. (31,32) Costs for biopsies and histopathology may be reduced by applying an optical diagnosis (24) and targeted biopsies (10) in daily practice.

Dual Focus may play an important role in optical diagnosis as it raises the ratio of high-confidence decisions – an important aspect to maximize the economic benefits of these strategies.

Why is colonoscopy under pressure to increase cost efficiency?

Colonoscopy is a clinically, as well as economically, effective modality for prevention of colorectal cancer. However, an increasing number of patients, as well as an increasing number of lesions also increase the need for time- and cost-effective procedures. In the esophagus, Barrett’s Esophagus is a major indication with increasing prevalence and significant costs for surveillance.(41)

Which procedural factors increase costs?

Apart from equipment costs, various factors influence cost efficiency (time required for the exam and patient recovery, staff required for the procedure, drugs being used, cost for histopathology or reprocessing).

Quality needs to be ensured.


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Clincial Studies

  • 1 - Update on Endoscopic Tissue Sampling Devices.

    Technology Assessment Committe:
    Barkun A, Liu J, Carpenter S, Chotiprasidhi P, Chuttani R, Ginsberg G, Hussain N, Silverman W, Taitelbaum G, Petersen BT.
    Gastrointest Endosc.
    2006 May
  • 2 - The Role of Endoscopy in Barrett‘s Esophagus and Other Premalignant Conditions of the Esophagus.

    ASGE Standards of Practice Committee:
    Evans JA, Early DS, Fukami N, Ben-Menachem T, Chandrasekhara V, Chathadi KV, Decker GA, Fanelli RD, Fisher DA, Foley KQ, Hwang JH, Jain R, Jue TL, Khan KM, Lightdale J, Malpas PM, Maple JT, Pasha SF, Saltzman JR, Sharaf RN, Shergill A, Dominitz JA, Cash BD;
    Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy.
    Gastrointest Endosc.
    2012 Dec;76(6):1087-94.
    doi: 10.1016/j.gie.2012.08.004.
  • 3 - American Gastroenterological Association Institute Guideline on the Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions

    Yang YX, Brill J, Krishnan P, Leontiadis G; American Gastroenterological Association Clinical Practice Guidelines Committee.
    Gastroenterology. 2015 Oct
    149(4):1082-7. doi: 10.1053/j.gastro.2015.07.039.
    Epub 2015 Aug 14.
  • 4 - The Role of Endoscopy in Inflammatory Bowel Disease

    American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, Early DS, Evans JA, Fanelli RD, Fisher DA, Fonkalsrud L, Foley K, Hwang JH, Jue TL, Khashab MA, Muthusamy VR, Pasha SF, Saltzman JR, Sharaf R, Cash BD, DeWitt JM.
    Gastrointest Endosc. 2015 May;
    81(5):1101-21.e1-13. doi: 10.1016/j.
    ie.2014.10.030. Epub 2015 Mar 20.
  • 5 - The Seattle Protocol Does Not More Reliably Predict the Detection of Cancer at the Time of Esophagectomy Than a Less Intensive Surveillance Protocol

    Kariv R, Plesec TP, Goldblum JR, Bronner M, Oldenburgh M, Rice TW, Falk GW.
    Clin Gastroenterol Hepatol. 2009 Jun;
    7(6):653-8; quiz 606. doi: 10.1016/j.
    cgh.2008.11.024. Epub 2008 Dec 13.
  • 6 - Random Biopsies Taken During Colonoscopic Surveillance of Patients with Longstanding Ulcerative Colitis: Low Yield and Absence of Clinical Consequences

    van den Broek FJ, Stokkers PC, Reitsma JB, Boltjes RP, Ponsioen CY, Fockens P, Dekker E.
    Am J Gastroenterol. 2014 May;
    109(5):715-22. doi:
    10.1038/ajg.2011.93. Epub 2011 Mar 22.
  • 7 - Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging

    Hewett DG, Kaltenbach T, Sano Y, Tanaka S, Saunders BP, Ponchon T, Soetikno R, Rex DK.
    Gastroenterology. 2012 Sep;
    143(3):599-607.e1. doi:
    10.1053/j.gastro.2012.05.006. Epub 2012 May 15.
  • 8 - Endoscopic Prediction of Deep Submucosal Invasive Carcinoma: Validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) Classification

    Hayashi N, Tanaka S, Hewett DG, Kaltenbach TR, Sano Y, Ponchon T, Saunders BP, Rex DK, Soetikno RM.
    Gastrointest Endosc. 2013 Oct;
    78(4):625-32. doi: 10.1016/j.gie.2013.04.185.
    Epub 2013 Jul 30.
  • 9 - Narrow-Band Imaging with Dual Focus Magnification in Differentiating Colorectal Neoplasia

    Singh R, Jayanna M, Navadgi S, Ruszkiewicz A, Saito Y, Uedo N.
    Dig Endosc. 2013 May;
    25 Suppl 2:16-20. doi: 10.1111/den.12075.
  • 10 - Standard Endoscopy with Random Biopsies Versus Narrow Band Imaging Targeted Biopsies in Barrett‘s Oesophagus: A Prospective, International, Randomised Controlled Trial

    Sharma P, Hawes RH, Bansal A, Gupta N, Curvers W, Rastogi A, Singh M, Hall M, Mathur SC, Wani SB, Hoffman B, Gaddam S, Fockens P, Bergman JJ.
    Gut. 2013 Jan;
    62(1):15-21. doi: 10.1136/gutjnl-2011-300962. Epub 2012 Feb 7.
  • 11 - Advanced Imaging Technologies Increase Detection of Dysplasia and Neoplasia in Patients with Barrett‘s Esophagus: A Meta-Analysis and Systematic Review

    Qumseya BJ, Wang H, Badie N, Uzomba RN, Parasa S, White DL, Wolfsen H, Sharma P, Wallace MB.
    Clin Gastroenterol Hepatol. 2013 Dec;
    11(12):1562-70.e1-2. doi: 10.1016/j. cgh.2013.06.017.
    Epub 2013 Jul 12.
  • 12 - White-Light or Narrow-Band Imaging Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study

    Leifeld L, Rogler G, Stallmach A, Schmidt C, Zuber-Jerger I, Hartmann F, Plauth M, Drabik A, Hofstädter F, Dienes HP, Kruis W; Detect Dysplasia Study Group.
    Clin Gastroenterol Hepatol. 2015 Oct;
    13(10):1776-1781.e1. doi: 10.1016/j. cgh.2015.04.172.
    Epub 2015 May 5.
  • 13 - Preliminary Feasibility Study Using a Novel Narrow-Band Imaging System with Dual Focus Magnification Capability in Barrett‘s Esophagus: Is the Time Ripe to Abandon Random Biopsies?

    Singh R, Shahzad MA, Tam W, Goda K, Yu LH, Fujishiro M, Uedo N, Ruszkiewicz A.
    Dig Endosc. 2013 May;
    25 Suppl 2:151-6. doi: 10.1111/den.12106.
  • 14 - Adenoma Detection Rate and Risk of Colorectal Cancer and Death

    van den Broek E, Richard W, van Tinteren H, et al.
    N Engl J Med. 2014 Apr 3;
  • 15 - Improving Measurement of the Adenoma Detection Rate and Adenoma Per Colonoscopy Quality Metric: The Indiana University Experience

    Kahi CJ, Vemulapalli KC, Johnson CS, Rex DK.
    Gastrointest Endosc. 2014 Mar;79(3):448-54.
  • 16 - Impact of Bowel Preparation with Low-Volume (2-Liter) and Intermediate-Volume (3-Liter) Polyethylene Glycol on Colonoscopy Quality: A Prospective Observational Study

    Cheng CL, Kuo YL, Liu NJ, Lin CH, Tang JH, Tsui YN, Lee BP, Su MY, Chiu CT.
    Digestion. 2015;92(3):156-64.
  • 17 - Adenoma Detection Rate Is not Influenced by the Timing of Colonoscopy When Performed in Half-Day Blocks

    Gurudu SR, Ratuapli SK, Leighton JA, Heigh RI, Crowell MD.
    Am J Gastroenterol. 2011 Aug;
    106(8):1466-71. doi: 10.1038/ajg.2011.125.
    Epub 2011 Apr 19.
  • 18 - A Patient-Blinded Randomized, Controlled Trial Comparing Air Insufflation, Water Immersion, and Water Exchange During Minimally Sedated Colonoscopy

    Hsieh YH, Koo M, Leung FW.
    Am J Gastroenterol. 2014 Sep;
    109(9):1390-400. doi: 10.1038/ajg.2014.126.
    Epub 2014 Jun 3.
  • 19 - High Definition Colonoscopy vs. Standard Video Endoscopy for the Detection of Colonic Polyps: A Meta-Analysis

    Subramanian V, Mannath J, Hawkey CJ, Ragunath K.
    Endoscopy. 2011 Jun;
    43(6):499-505. doi: 10.1055/s-0030-1256207.
    Epub 2011 Feb 28.
  • 20 - Detection of Colorectal Adenoma by Narrow Band Imaging (HQ190) vs. High-Definition White Light Colonoscopy: A Randomized Controlled Trial

    Leung WK, Lo OS, Liu KS, Tong T, But DY, Lam FY, Hsu AS, Wong SY, Seto WK, Hung IF, Law WL.
    Am J Gastroenterol. 2014 Jun;
    109(6):855-63. doi: 10.1038/ajg.2014.83.
    Epub 2014 Apr 22.
  • 21 - Next-Generation Narrow Band Imaging System for Colonic Polyp Detection: A Prospective Multicenter Randomized Trial

    Horimatsu T, Sano Y, Tanaka S, Kawamura T, Saito S, Iwatate M, Oka S, Uno K, Yoshimura K, Ishikawa H, Muto M, Tajiri H.
    Int J Colorectal Dis. 2015 Jul;
    30(7):947-54. doi: 10.1007/s00384-015-2230-x.
    Epub 2015 Apr 30.
  • 22 - Narrow Band Imaging to Differentiate Neoplastic and Non-Neoplastic Colorectal Polyps in Real Time: A Meta-Analysis of Diagnostic Operating Characteristics

    McGill SK, Evangelou E, Ioannidis JP, Soetikno RM, Kaltenbach T.
    Gut. 2013 Dec;
    62(12):1704-13. doi: 10.1136/gutjnl-2012-303965.
    Epub 2013 Jan 7.
  • 23 - Diagnostic Performance of Narrowed Spectrum Endoscopy, Autofluorescence Imaging, and Confocal Laser Endomicroscopy for Optical Diagnosis of Colonic Polyps: A Meta-Analysis

    Wanders LK, East JE, Uitentuis SE, Leeflang MM, Dekker E.
    Lancet Oncol. 2013 Dec;
    14(13):1337-47. doi: 10.1016/S1470-2045(13)70509-6.
    Epub 2013 Nov 13.
  • 24 - ASGE Technology Committee Systematic Review and Meta-Analysis Assessing the ASGE PIVI Thresholds for Adopting Real-Time Endoscopic Assessment of the Histology of Diminutive Colorectal Polyps

    ASGE Technology Committee, Abu Dayyeh BK, Thosani N, Konda V, Wallace MB, Rex DK, Chauhan SS, Hwang JH, Komanduri S, Manfredi M, Maple JT, Murad FM, Siddiqui UD, Banerjee S.
    Gastrointest Endosc. 2015 Mar;
    81(3):502.e1-502.e16. doi: 10.1016/j.gie.2014.12.022.
    Epub 2015 Jan 16.
  • 25 - Real-Time Optical Diagnosis for Diminutive Colorectal Polyps Using Narrow-Band Imaging: The VALID Randomised Clinical Trial

    Kaltenbach T, Rastogi A, Rouse RV, McQuaid KR, Sato T, Bansal A, Kosek JC, Soetikno R.
    Gut. 2015 Oct;
    64(10):1569-77. doi: 10.1136/gutjnl-2014-307742.
    Epub 2014 Nov 11.
  • 26 - Advanced Imaging for Detection and Differentiation of Colorectal Neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

    Kamiński MF, Hassan C, Bisschops R, Pohl J, Pellisé M, Dekker E, Ignjatovic-Wilson A, Hoffman A, Longcroft-Wheaton G, Heresbach D, Dumonceau JM, East JE.
    Endoscopy. 2014 May;
    46(5):435-49. doi: 10.1055/s-0034-1365348.
    Epub 2014 Mar 17.
  • 27 - An Analysis of the Learning Curve to Achieve Competency at Colonoscopy Using the JETS Database

    Ward ST, Mohammed MA, Walt R, Valori R, Ismail T, Dunckley P.
    Gut. 2014 Nov;
    63(11):1746-54. doi: 10.1136/gutjnl-2013-305973.
    Epub 2014 Jan 27.
  • 28 - Patient Pain During Colonoscopy: An Analysis Using Real-Time Magnetic Endoscope Imaging

    Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP.
    Endoscopy. 2002 Jun;
  • 29 - Magnetic Endoscopic Imaging Versus Standard Colonoscopy in a Routine Colonoscopy Setting: A Randomized, Controlled Trial.

    Holme Ö, Höie O, Matre J, Stallemo A, Garborg K, Hasund A, Wiig H, Hoff G, Bretthauer M.
    Gastrointest Endosc. 2011 Jun;
    73(6):1215-22. doi: 10.1016/j.gie.2011.01.054.
    Epub 2011 Apr 8.
  • 30 - Magnetic Endoscopic Imaging Versus Standard Colonoscopy: Meta-Analysis of Randomized Controlled Trials

    Chen Y, Duan YT, Xie Q, Qin XP, Chen B, Xia L, Zhou Y, Li NN, Wu XT.
    World J Gastroenterol. 2013 Nov 7;
    19(41):7197-204. doi: 10.3748/wjg.v19.i41.7197.
  • 31 - Magnetic Endoscopic Imaging as an Adjuvant to Elective Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Mark-Christensen A, Brandsborg S, Iversen LH.
    Endoscopy. 2015 Mar;
    47(3):251-61. doi: 10.1055/s-0034-1390767.
    Epub 2014 Dec 18.
  • 32 - Sedation for Colonoscopy with a New Ultrathin or a Standard Endoscope: A Prospective Randomized Controlled Study

    Töx U, Schumacher B, Toermer T, Terheggen G, Mertens J, Holzapfel B, Lehmacher W, Goeser T, Neuhaus H.
    Endoscopy. 2013 Jun;
    45(6):439-44. doi: 10.1055/s-0032-1326270.
    Epub 2013 Mar 6.
  • 33 - Conscious Sedation and Analgesia in Colonoscopy

    Khajavi M, Emami A, Etezadi F, Safari S, Sharifi A, Shariat Moharari R.
    Anesth Pain Med. 2013 Summer;
    3(1):208-13. doi: 10.5812/aapm.9653.
    Epub 2013 Jul 1.
  • 34 - Safety analysis of endoscopist-directed sedation

    Sieg A; bng-Study-Group, Beck S, Scholl SG, Heil FJ, Gotthardt DN, Stremmel W, Rex DK, Friedrich K.
    J Gastroenterol Hepatol. 2014 Mar;
  • 35 - Position Change During Colonoscope Withdrawal Increases Polyp and Adenoma Detection in the Right but not in the Left Side of the Colon: Results of a Randomized Controlled Trial

    Ball AJ, Johal SS, Riley SA.
    Gastrointest Endosc. 2015 Sep;
    82(3):488-94. doi: 10.1016/j.gie.2015.01.035.
    Epub 2015 Apr 22.
  • 36 - Variable Stiffness Colonoscope Versus Regular Adult Colonoscope: Meta-Analysis of Randomized Controlled Trials

    Othman MO, Bradley AG, Choudhary A, Hoffman RM, Roy PK.
    Endoscopy. 2009 Jan;
    41(1):17-24. doi: 10.1055/s-0028-1103488.
    Epub 2009 Jan 21.
  • 37 - Does “Responsive Insertion Technology” Improve Practice of Colonoscopy? Results of a Randomized Study

    Cuesta R, Sola-Vera J, Uceda F, García Sepulcre MF, Morillo E, Vázquez N.
    Scand J Gastroenterol. 2014 Mar;
    49(3):355-61. doi: 10.3109/00365521.2013.871576.
    Epub 2014 Jan 13.
  • 38 - Long-Term Colorectal-Cancer Incidence and Mortality after Lower Endoscopy

    Nishihara R, Wu K, Lochhead P, Morikawa T, Liao X, Qian ZR, Inamura K, Kim SA, Kuchiba A, Yamauchi M, Imamura Y, Willett WC, Rosner BA, Fuchs CS, Giovannucci E, Ogino S, Chan AT.
    N Engl J Med. 2013 Sep 19;
    369(12):1095-105. doi: 10.1056/NEJMoa1301969
  • 39 - The Comparative Cost-Effectiveness of Colorectal Cancer Screening Using Faecal Immunochemical Test Versus Colonoscopy

    Wong MC, Ching JY, Chan VC, Sung JJ.
    Sci Rep. 2015 Sep 4;
    5:13568. doi: 10.1038/srep13568.
  • 40 - Trends in Adenoma Detection Rates During the First 10 Years of the German Screening Colonoscopy Program

    Brenner H, Altenhofen L, Kretschmann J, Rösch T, Pox C, Stock C, Hoffmeister M
    Gastroenterology. 2015 Aug;
    149(2):356-66.e1. doi: 10.1053/j.gastro.2015.04.012.
    Epub 2015 Apr 22.
  • 41 - Global Epidemiology of Barrett‘s Esophagus

    Fock KM, Ang TL.
    Expert Rev Gastroenterol Hepatol. 2011 Feb;
    5(1):123-30. doi: 10.1586/egh.10.82.
  • 42 - Cost Considerations in Implementing a Screening and Surveillance Strategy for Barrett‘s Oesophagus

    Inadomi JM.
    Best Pract Res Clin Gastroenterol. 2015 Feb;
    29(1):51-63. doi: 10.1016/j. bpg.2014.12.002.
    Epub 2014 Dec 18.
  • 43 - Narrow Band Imaging with Magnification Endoscopy for Celiac Disease: Results from a Prospective, Single-Center Study

    De Luca L, Ricciardiello L, Rocchi MB, Fabi MT, Bianchi ML, de Leone A, Fiori S, Baroncini D.
    Diagn Ther Endosc. 2013;
    2013:580526. doi: 10.1155/2013/580526.
    Epub 2013 Aug 6.
  • 44 - Carbon Dioxide Insufflation Versus Conventional Air Insufflation for Colonoscopy: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials

    Sajid MS, Caswell J, Bhatti MI, Sains P, Baig MK, Miles WF.
    Colorectal Dis. 2015 Feb;
    17(2):111-23. doi: 10.1111/codi.12837.
  • 45 - ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus.

    ASGE Technology Committee, Thosani N, Abu Dayyeh BK, Sharma P, Aslanian HR, Enestvedt BK, Komanduri S, Manfredi M, Navaneethan U, Maple JT, Pannala R, Parsi MA, Smith ZL, Sullivan SA, Banerjee S.
    ASGE Technology Committee et al. Gastrointest Endosc. 2016 Apr;
  • 46 - Reduced Pain During Screening Colonoscopy with an Ultrathin Colonoscope: A Randomized Controlled Trial

    Garborg KK, Løberg M, Matre J, Holme O, Kalager M, Hoff G, Bretthauer M.
    Endoscopy. 2012 Aug;
    44(8):740-6. doi: 10.1055/s-0032-1309755.
    Epub 2012 May 23.
  • 47 - Longer Withdrawal Time Is Associated With a Reduced Incidence of Interval Cancer After Screening Colonoscopy.

    Shaukat A, Rector TS, Church TR, Lederle FA, Kim AS, Rank JM, Allen JI.
    Shaukat et al. 2015; Gastroenterology 2015 Jul 9 (ahead of print)
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* The term "Proven" refers to the clinical outcomes reported in the numerous studies listed on this webpage.  Actual outcomes experienced in the individual clinical setting are reliant upon a number of environmental factors and may vary.