Polyp Detection With The Peerscope System™
Condition: Colon Polyps and Adenomas; Colon Cancer
MeSH terms: Adenoma; Polyps
Study type: Interventional
Phase: Phase 2

Summary: 
      The PeerScope System consists of Peer Medical camera heads, endoscopes, video system, light
      source and other ancillary equipment. The system is intended for endoscopic diagnosis,
      treatment and video observation of the digestive tract. The PeerScope system model B is
      indicated for use for endoscopy and endoscopic treatment within the lower digestive tract
      (including the anus, rectum, sigmoid colon, colon and ileocecal valve) of adults patients.

      Objective:To compare the additional diagnostic yield obtained by using the PeerScope System™
      extended view vs. the diagnostic yield obtained by the Standard view colonoscopy.

      In addition, time measurements including time to cecum, time for withdrawal and overall
      procedure time will be analyzed and reported for each group.
    

Detailed description: 
      Design:

      Patients who are scheduled for screening, surveillance or diagnostic colonoscopy will be
      recruited to the study and randomized to one of two groups. Each enrolled subject will
      undergo two "back-to-back" procedures.

      Subjects in Group A (study group) will undergo a Standard view colonoscopy followed
      immediately by a PeerScope System™ extended view colonoscopy. Subjects in Group B (control
      group) will undergo a PeerScope System™ extended view colonoscopy followed immediately by a
      Standard view colonoscopy.

      Results from the two groups will be analyzed and compared, with primary outcome measures
      being detection rates for total polyps and detection rates for adenomas. Secondary outcome
      measures will include withdrawal time, total procedure time and characteristics of polyps
      detected, including size and histological results.

      Subjects will be followed through a 24 hour and a 7 days telephone interview for analysis of
      unexpected adverse events. Clinical results will be analyzed using various statistical
      measures of significance.

      Study Design:

      Multi-center study with up to 196 patients. No. of Patients:

      Up to 196 treated patients will be enrolled into the study. Primary Performance Endpoint:

        -  Standard view colonoscopy adenoma overall detection rate compared to the extended view
           overall adenoma detection rate using the PeerScope System™

        -  Standard view colonoscopy overall polyp detection rate compared to the extended view
           overall polyp detection rate using the PeerScope System™.

      Safety Analysis:

      Incidence of device-related and procedure-related serious adverse events. Incidence of
      complications using PeerScope System™

      Known complications include:

        -  Perforation;

        -  Severe abdominal pain;

        -  Infection;

        -  Bleeding (other than expected minor bleeding due to therapeutic procedures e.g.
           polypectomy);

        -  Inducing inflammation of diverticulum

        -  Arrhythmia, bradycardia, hypotension, hypoxia

        -  Death

      Secondary Endpoints / Other Outcomes:

        1. Performance of therapeutic interventions, such as biopsies, polypectomies, APC etc.

        2. Procedure time. The following will be recorded: a. Time for intubation to the cecum. b.
           Time for withdrawal from the cecum to the anal verge. c. Total procedure time A
           stopwatch will be used for stopping the timing of the procedure for any polypectomy
           performed and then restarting once the polypectomy is completed, meaning that purely
           procedure time is measured

        3. Sedation dosage

        4. Patient satisfaction. Patient's pain at the end of the procedure will be recorded using
           VAS scale. Results of 24 hour telephone follow-up to assess for post-procedural patient
           satisfactory will be recorded on the CRF.

      Inclusion criteria:

        -  Subject between the ages of 18 and 70

        -  The patient is undergoing colonoscopy for screening, for surveillance in follow-up of
           previous polypectomy or for diagnostic workup;

        -  Written informed consent must be available before enrollment in the trial

        -  For women with childbearing potential, adequate contraception

      Exclusion criteria:

        -  Patients with a history of colonic resection;

        -  Patients with known (or newly diagnosed) inflammatory bowel disease;

        -  Patients with a personal history of polyposis syndrome;

        -  Patients with suspected chronic stricture potentially precluding complete colonoscopy;

        -  Patients with diverticulitis or toxic megacolon;

        -  Patients with a history of radiation therapy to abdomen or pelvis;

        -  Patients with acute lower GI bleeding

        -  Patients who are currently enrolled in another clinical investigation in which the
           intervention might compromise the safety of the patient's participation in this study.
    

Intervention name(s): Colonoscopy done with:PeerMedical System and Olympus/Pentax/Fuji colonoscopy system
Intervention type(s): Device
Intervention description(s): endoscopic diagnosis, treatment and video observation of the digestive tract, endoscopy and endoscopic treatment within the lower digestive tract (including the anus, rectum, sigmoid colon, colon and ileocecal valve) of adults patients
Other intervention name(s): Colonoscopy; Polyp detection; Screening
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Screening