Endocuff to Improve Adenoma Detection: Supported by Low-Quality Evidence or Not Supported by High-Quality Evidence?

We read with great interest the network meta-analysis by Facciorusso et al1 that compared the efficacy of add-on devices with each other or with standard colonoscopy. Facciorusso et al1 are to be commended for their excellent work on investigating the effect of add-on devices on colonoscopy performance. Among the add-on devices, it has been reported that Endocuff (ARC Medical Design, Leeds, UK) is safe, effective, easy to handle, and may improve both the adenoma detection rate (ADR) and control of the tip of the colonoscope, and might reduce colorectal interval carcinomas.

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