CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(12): E1235-E1241
DOI: 10.1055/s-0043-120659
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

A novel lens cleaner to prevent water drop adhesions during colonoscopy and esophagogastroduodenoscopy

Naohisa Yoshida1, Yuji Naito1, Ritsu Yasuda1, Takaaki Murakami1, Kiyoshi Ogiso1, Ryohei Hirose1, Yutaka Inada1, Osamu Dohi1, Tetsuya Okayama1, Kazuhiro Kamada1, Kazuhiko Uchiyama1, Takeshi Ishikawa1, Osamu Handa1, Hideyuki Konishi1, Rafiz Abdul Rani2, Yoshito Itoh1
  • 1Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
  • 2Gastroenterology Unit, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
Further Information

Publication History

submitted 20 March 2017

accepted after revision 07 September 2017

Publication Date:
06 December 2017 (online)


Background and study aims Water drop adhesions (WDA) impair endoscopic view during gastrointestinal endoscopy. We developed a novel lens cleaner designed using two types of harmLess surfactants and it is reported to be useful for preventing lens cloudiness during colorectal ESD. In the current study, we examined the ability of it for preventing and removing WDA.

Patients and methods During laboratory experiments, the cleaner (Cleash; Fujifilm Co., Tokyo, Japan and Nagase Medicals Co., Hyogo, Japan) was applied to the endoscopic lens and an air/water device (AWD) (water 200 mL, dimethicone 1 mL, Cleash 1 mL). The endoscope was submerged in water 100 times for 5 cycles. Rates of WDA were calculated for various groups (lens and AWD with or without Cleash) and compared to a normal cleaner (SL cleaner). During clinical research, 30 colonoscopies and 30 esophagogastroduodenoscopies were analyzed. For the Cleash group, the cleaner was applied to both lens and AWD. The numbers of WDA and WDA with non-rapid removal were calculated, compared to those of the SL cleaner group.

Results The mean WDA rate for the Cleash setting (lens: Cleash; AWD: Cleash) was 11.0 %, which was significantly lower than other settings (lens: SL cleaner; AWD: water, 31.0 %; P < 0.001) (lens: Cleash; AWD: water, 19.0 %; P < 0.001). Clinical research of colonoscopies indicated that the numbers of WDA (number/15 sec) and WDA with non-rapid removal were 0.38 and 0.17 for the Cleash group and 0.91 and 0.46 for the SL cleaner groups (P < 0.001, P < 0.001). For esophagogastroduodenoscopies, the results were 0.47 and 0.24 for the Cleash group and 0.54 and 0.42 for the SL cleaner group (P = 0.72, P = 0.018).

Conclusion A clear and beautiful image without WDA is useful not only for routine endoscopy but also, more importantly, for magnifying endoscopy and other endoscopic treatments. The use of Cleash to lens and AWD showed positive results for preventing and removing WDA during laboratory experiments and clinical research involving CS. Additionally, it also showed positive results for the removal of WDA during EGD.