Commentary

10.1055/a-2616-8361

Before resecting a diminutive polyp, we should be aware that every unnecessary intervention has an environmental cost. The resect-and-discard and leave-in-situ strategies represent powerful opportunities to reduce the environmental footprint of colonoscopy. European Society of Gastrointestinal Endoscopy (ESGE) guidelines endorse these approaches provided that optical diagnosis achieves high accuracy (>90% sensitivity and specificity). Yet, uptake in daily practice has been limited, not only because of concerns about reliability and training, but also due to the cumbersome nature of implementation and the lack of practical tools to facilitate it.

The CONECCTapp presented in this E-Video by Costaouec et al. provides an innovative solution. Based on CONECCT classification, it enables endoscopists to characterize diminutive polyps and compare their predictions with histology. The app generates the personalized sensitivity and specificity of the endoscopist’s prediction, and an „action score“ reflecting the clinical safety. Importantly, it also allows users to quantify their potential carbon footprint reduction, linking performance in optical diagnosis with measurable ecological benefit.

Publication History

Article published online:
28 October 2025