Methods: Major databases were searched to obtain research reports that could potentially shape clinical practice related to WAC and UWR. We conducted a modified Delphi consensus among experienced colonoscopists on definitions and practice of water immersion (WI), water exchange (WE), and UWR. We reviewed and graded the research evidence with potential clinical application. Background and Aims: Since 2008, a plethora of research studies has compared the efficacy of water-assisted (aided) colonoscopy (WAC) and underwater resection (UWR) of colorectal lesions with standard colonoscopy.
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