Polyp Detection With The Peerscope System™

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.

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.