Colonoscopy is the gold standard for colorectal cancer screening, yet up to one-third of adenomas may remain undetected due to limited mucosal visibility, particularly in hidden areas such as the sigmoid colon and caecum. Endocuff Vision (EC), an add-on device with flexible projections designed to flatten colonic folds, has emerged as a promising tool to improve mucosal exposure and optimize detection rates. The aim of this study is to evaluate whether the use of Endocuff Vision enhances polyp and adenoma detection compared with standard colonoscopy.

A prospective randomized study was conducted in the our Department of CHU Mohammed. Twenty-five patients undergoing colorectal adenoma screening were enrolled. All underwent standard colonoscopy with or without EC assistance. Outcomes included polyp detection rate (PDR), adenoma detection rate (ADR), number of polyps per patient, segmental lesion distribution, and safety. Statistical analysis was performed to compare both groups.

The EC group demonstrated a 63% higher number of polyps detected per patient compared with standard colonoscopy [2.00 (IQR 1.00–4.00) vs 1.00 (IQR 1.00–2.25), p < 0.0001]. PDR improved by 14% with EC assistance (56% vs 42%, p = 0.001).Significant superiority was observed for polyps <1 cm in the sigmoid colon (p = 0.001) and caecum (p = 0.002).ADR increased by 86% in the EC group (p = 0.002).No major complications occurred in either group.

Endocuff Vision significantly improves both polyp and adenoma detection, particularly in anatomically challenging segments. The device is safe, feasible, and easy to integrate into routine practice. Its adoption may enhance the effectiveness of colorectal cancer screening programs by reducing missed lesions.