S1282 Clearer View, Quicker Resection: Assessing the Role of Endocuff Vision in Endoscopic Mucosal Resection (EMR)

Introduction: Endocuff Vision (EV) is a distal colonoscope attachment designed to enhance mucosal visualization and scope stability. Its impact on endoscopic mucosal resection (EMR) outcomes, particularly regarding recurrence, visualization, and procedural efficiency, remains underexplored. By improving exposure of the colonic mucosa, the EV may facilitate more complete polyp resection, potentially reducing the rates of recurrence. This study evaluates EMR outcomes performed with versus without EV assistance. Methods: We conducted a retrospective case-control study of patients who underwent cold-snare EMR at a tertiary academic center between January 2023 and December 2024. Resected polyps were divided into 2 groups: those removed with use of the EV (case group) and those without (control group). Demographics, polyp characteristics, procedural details, and follow-up outcomes were compared. Continuous variables were analyzed using t-tests and categorical variables using Chi-square tests. Results: A total of 111 polyps were removed from 84 patients using cold-snare EMR. Of these, 53 (47.7%) were resected with EV assistance and 58 (52.3%) without. The groups were similar in age, sex, and race. The EV group had fewer ASA grade 3 patients (13.2% vs 32.8%, P = 0.016) and a lower prevalence of smoking (28.3% vs 51.7%, P = 0.021). There were no significant differences in the mean number of polyps removed (1.79 vs 1.86, P = 0.804), polyp size (16.7 mm vs 14.9 mm, P = 0.084), and location. Procedures performed with EV had a significantly shorter duration compared to those without (34.96 ± 11.49 vs 47.43 ± 15.14 minutes, P < 0.001). There was also a trend toward reduced prophylactic clip usage in the EV group (17.0% vs 34.5%, P = 0.060). No significant differences were observed in recurrence rates (17.0% vs 12.1%, P = 0.642) and follow-up intervals were similar (6.9 vs 6.4 months, P = 0.444) between the 2 groups. Conclusion: EMR performed with EV is safe and achieves clinical outcomes comparable to standard EMR. Notably, EV use was associated with a significantly shorter procedure duration, suggesting improved efficiency related to mucosal visualization and scope control. A trend toward reduced prophylactic clip use was also observed. However, recurrence rates and other clinical outcomes remained similar between groups. Larger prospective studies are warranted to assess whether the procedural advantages of EV translate to improved long-term outcomes.