3 Things Your Patients Should Know About Endoscopic Tattooing (Before the Colonoscopy)

3 Things Your Patients Should Know About Endoscopic Tattooing (Before the Colonoscopy)

In 2018, the American Cancer Society projects there will be nearly 100,000 new cases of colon cancer, and colonoscopies will play a vital role in diagnosing those cases. Though patient awareness of this procedure has grown significantly in recent years, in part to efforts like Colon Cancer Awareness Month in March, there’s still plenty of education to be done around its importance. That includes educating patients about the need for future follow-up colonoscopies and the role endoscopic tattooing plays in ensuring endoscopists are consistently monitoring their health.

Most patients are unfamiliar with endoscopic tattooing or its value in long-term surveillance of colon cancer. Educating patients on this important piece of cancer care can give them extra comfort that their GI team is taking every step possible to help them monitor and prevent recurrence (interval cancer). Here are the top three things your patients should know about endoscopic tattooing (before the colonoscopy):

Tattooing Plays a Very Important Role in Patient Care

The two most important reasons to tattoo your patients are:

  1. When being referred for surgery.
  2. When your patient will be brought back for surveillance colonoscopy.

The value of tattooing prior to surgery is clear.  A tattoo helps communicate to the surgeon where a lesion is that was identified during colonoscopy.  In 2007, a paper published in the “World Journal of Surgery” reported that 98% of tattooed tumors were found in surgery, saving time by easily identifying harder to find lesions.1 Artega-Gonzalez and team showed that surgeons save up to 40 minutes of operating room time by improving localization.2

Despite new ESGE guidelines that call for tattooing all lesions removed by polypectomy and EMR that will require future colonoscopy,3 most of these patients are not tattooed.  However, tattooing for clinical surveillance adds value by speeding up localization and ensuring you are following the same tissue after it’s healed.  For your patients, it also ensures that any gastroenterologist can monitor their progression regardless of who they see or if they move.

Tattooing is Society Recommended

Endoscopic tattooing has proven itself as reliable and is recognized as an integral tool for colon cancer surveillance. In addition to the ESGE guidelines, endoscopic tattooing is society recommended by the American College of Gastroenterology,4 the British Society of Gastroenterology,5 and the Society of American Gastrointestinal Endoscopic Surgeons.6

Spot® Ex Endoscopic Tattoo Meets New Clinical Guidelines

Since the procedure was introduced, a variety of solutions have been used for endoscopic tattooing, but only one is recommended by the newly updated clinical guidelines from the ESGE.3 Spot® was recommended for its “accessibility, ease of use, and safety,” and our new and improved Spot® Ex has all of that plus it’s permanent and darker than its predecessor.7,8

In the ongoing fight against colon cancer, it’s all hands on deck as we all work to eradicate this preventable disease. Strong surveillance that includes endoscopic tattooing will be key to the prevention and management of colorectal cancers.

Since 2000 Spot has been the go-to solution for endoscopic tattooing, but a new and improved, simpler, permanent version, Spot Ex, is now available. Learn more about Spot Ex here:

Learn More About Spot® Ex

1 – Cho Y, Lee W, Yun H, Lee W, Yun S, Chun H. Tumor Localization for Laparoscopic Colorectal Surgery. World J Surg. 2007.
2 – Arteaga-Gonzalez I, et. al., The use of preoperative endoscopic tattooing in laparoscopic colorectal cancer surgery for endoscopically advanced tumors: a prospective comparative clinical study. World J Surg. 2006. 30(4):605–611
3 –  Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): ESGE Clinical Guideline. 2017.
4 – Rex D, Schoenfeld P, Cohen J, et al. Quality Indicators for Colonoscopy. Am J Gastroenterol. 2014: 1-19.
5 – Rees C, Bevan R, Zimmerman-Fraedrch K, et al. Expert opinions and scientific evidence for colonoscopy key performance indications. Gut BMJ. 2016.
6 – SAGES. Guidelines for laparoscopic resection of curable colon and rectal cancer. 2012.
7 – Spot Ex Luminosity Lab Results. Northwestern Biological Imaging Facility. Nov 2017.
8 –  Spot Ex. Instructions for Use. Rev 03. May 2018.