Transparent hood attached to the colonoscope: does it really work for all types of colonoscopes?

Background Recently the use of a transparent hood attached to the tip of the colonoscope has been reported to be useful in cecal intubation, especially in difficult colonoscopy cases. However, patient comfort with or without the use of a transparent hood, the type of colonoscope most suitable for this device have not been fully evaluated. Methods A total of 372 patients undergoing routine colonoscopy were evaluated. No sedatives were used as a principle, and patients with prior abdominal surgery were excluded. A single endoscopist performed all the examinations. Four types of colonoscopes were used: CF-230I and CF-Q240AI as a standard colonoscope, PCF-240I and PCF-P240AI as a small-caliber colonoscope (Olympus, Tokyo, Japan). A disposable transparent hood was used (Olympus, Tokyo, Japan). Patients were randomly divided into four groups; standard colonoscope without transparent hood (96 patients), standard colonoscope with transparent hood (82 patients), small-caliber colonoscope without transparent hood (102 patients), and small-caliber colonoscope with transparent hood (92 patients). Cecal intubation time, rate, modified visual analogue scale (VAS) of patient's pain, and technical difficulty were evaluated among the four groups. Results Standard colonoscope with the transparent hood showed the shortest cecal intubation time, and lowest modified VAS scale of pain and technical difficulty among the four groups. However there was no significant difference with regard to small-caliber colonoscopes with or without the transparent hood. Conclusions Transparent hood may be a handy and a cost-effective device for reducing pain and simplifying cecal intubation, especially when using a standard adult colonoscope in routine colonoscopy.