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How it Works

ENDOCUFF VISION™ is a device attached to the distal end of a colonoscope, designed to maintain and maximise the viewable mucosa during endoscopic therapy by manipulating colonic folds.

A single row of flexible arms evert and flatten folds to provide an enhanced view of the entire colon and to decrease the polyp miss rate. 8

Adenoma Detection Rate
Increases the adenoma detection rate by up to 11% (result of meta-analysis) — for every 1,000 patients screened, it is estimated that up to 110 patients with an adenoma could have been additionally identified using the ENDOCUFF technology 15

A 1% Increase in ADR Leads To:

  • 3% decrease in the risk of interval cancer. 5
  • 5% decrease in the risk of a fatal interval colorectal cancer. 5

Widely tested in 12 randomised controlled trials with more than 8,000 patients and 140 colonoscopists, plus experts and endoscopists 15

ENDOCUFF VISION™ shows no adverse or serious adverse events when tested in over 800 patients by 70 endoscopists 11

Causes for Concern with Unseen Adenomas and Polyps:

  • 24% of adenomas are missed with standard colonoscopy. 7
  • 40% of polyps go undetected. 8

ENDOCUFF VISION™ maximises visualisation during a colonoscopy, decreasing the overall polyp miss rate. 10


  1. 1.The difficult colonoscopy Can J Gastroenterol. 2007;21(8):487-490 Witte TN, Enns R.
  2. 2.Serrated Lesions of the Colorectum: Review and Recommendations From an Expert Panel Am J Gastroenterol. 2012;107(9):1315-1329 Rex DK, Ahnen DJ, Baron JA, et al.
  3. 3.Location of Adenomas Missed by Optical Colonoscopy Ann Intern Med. 2004;141(5):352-359 Pickhardt PJ, Nugent PA, Mysliwiec PA, et al.
  4. 4.Normal Adult Colonic Anatomy in Colonoscopy Video Journal and Encyclopedia of GI Endoscopy. 2013;1(2):390-392. Jayasekeran V, Holt B, Bourke M.
  5. 5.Adenoma Detection Rate and Risk of Colorectal Cancer and Death N Engl J Med. 2014;370(14):1298-1306. Corley DA, Jensen CD, Marks AR, et al.
  6. 6.Variation in Adenoma Detection Rate and the Lifetime Benefits and Cost of Colorectal Cancer Screening: A Microsimulation Model JAMA. 2015;313(23):2349-2358. Meester RG, Doubeni CA, Lansdorp-Vogelaar I, et al.
  7. 7.Impact of a new distal attachment on colonoscopy performance in an academic screening center Gastrointest Endosc, 87(1), 280-287. doi:10.1016/j.gie.2017.04.001 Tsiamoulos Z.P., Misra R., et al.
  8. 8.Endoscopy and polyps — diagnostic and therapeutic advances in management World J Gastroenterol. 2013;19(27):4277-4288. Steele SR, Johnson EK, Champagne B, et al.
  9. 9.Quality indicators for colonoscopy Gastrointest Endosc. 2015;81(1):31-53. Rex DK, Schoenfeld PS, Cohen J, et al.
  10. 10.Higher Adenoma Detection Rates with Endocuff-Assisted Colonoscopy — A Randomised Controlled Multicenter Trial PLoS One, 9(12), e114267. doi:10.1371/journal.pone.0114267 Floer M, Biecker E, Fitzlaff R, et al.
  11. 11.Improved Adenoma Detection with Endocuff Vision: The ADENOMA randomizsed controlled trial Gut, 68(2), 280-288. doi:10.1136/gutjnl-2017-314889 Ngu WS, Bevan R, Tsiamoulos Z.P., et al.
  12. 12.Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths Med 2012; 366:687-696 Zauber et al. N Engl J
  13. 13.Protection from colorectal cancer after colonoscopy: a population-based, case-control study Ann Intern Med. 2011 Jan 4;154(1):22-30. Brenner et al.
  14. 14.Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial BMJ. 2009 May 29;338:b1846. doi: 10.1136/bmj.b1846. (Bretthauer Group) Hoff et al.
  15. 15.Effect of Endocuff-assisted colonoscopy on adenoma detection rate: meta-analysis of randomised controlled trials Endoscopy, 50(9), 846-860. doi:10.1055/a-0577-3500 Williet, N., Tournier, Q., et al.
  16. 16.Endocuff Vision Reduces Inspection Time Without Decreasing Lesion Detection in a Randomised Colonoscopy Trial Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2019.01.015 Rex, D. K., Slaven, J. E., et al.
  17. 17.Quality Indicators for Colonoscopy and the Risk of Interval Cancer N Engl J Med 2010; 362:1795-1803 Kaminski, M. F., et al. (2010)
  18. 18.ENDOCUFF VISION™ for assisting visualisation during colonoscopy. Medical technologies guidance
  19. 19.Improved adenoma detection with ENDOCUFF VISION™: the ADENOMA randomised controlled trial. Gut 68(2): 280-288. Ngu, W. S., Bevan R., Tsiamoulos Z.P., et al. (2018).
  20. 20.Innovation and Technology Payment 2019/20 NHS England (2019).
  21. 21.2019 “www.bankofengland.co.uk” Bank of England exchange rate, July 19

Interview with Douglas K. Rex, M.D., Indiana University School of Medicine, USA

What do experienced users of ENDOCUFF VISION™ say?
In this video, Douglas K. Rex, M.D., shares his experience of using ENDOCUFF VISION and points out its benefits during routine colonoscopies.

Colonoscopy – How it Saves Lives

Colorectal cancer is a leading cause of cancer death for both men and women. Research has confirmed that regular colorectal cancer screening is one of the most powerful weapons against colorectal cancer. The best prevention for colon cancer is the early detection and removal of adenomatous polyps. Colonoscopy is considered the best method for detection and removal. 12,13,14

ENDOCUFF VISION™ is a device attached to the distal end tip of a colonoscope, focusing on the detection of adenomatous polyps (or adenomas) that are hard to find: some are small and flat, some hide behind folds or they are hidden by colonic flexure, or fecal material. 1,2,3,4 Designed to increase the adenoma detection rate (measurement of the effectiveness of the colonoscopy), ENDOCUFF VISION™ maximises visualisation by flattening or stretching mucosal folds while helping improve control during colonoscopy. 10

“We can prevent colon cancer - that’s an extremely powerful argument in its favor.”
Prof. Dr. med. Juergen Pohl | GastroClinic – Asklepios Klinik Altona