The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase II project is in addressing an unmet need in incomplete colonoscopy procedures. Incomplete colonoscopy procedures can result in missed colorectal cancer and ultimately increased healthcare expenditures related to follow-up procedures. Use of current balloon overtubes during colonoscopy can significantly improve cecal intubation rates and overall outcomes; However, operating in todays healthcare economy, colonoscopies and small bowel endoscopy are modestly reimbursed placing considerable pressure on the endoscopist to maximize patient throughput in an endoscopy lab at minimal cost. Current balloon overtubes are not widely utilized except in challenging and highly tortuous conditions due to their troublesome slippage and inefficient application. This project will provide endoscopists with an intraoperative tool that can transition incomplete colonoscopies to completed procedures at a fraction of the cost.This Small Business Innovation Research (SBIR) Phase II project seeks to demonstrate the feasibility of an integrated balloon overtube that can be used intraoperatively. The technology represents a mid-procedure, time-efficient addition on the endoscope to aid in completing challenging colonoscopies and minimize the occurrence of incomplete colonoscopies. The goal of this project is to achieve a safe, effective, manufacturable device that exhibits a clinically acceptable user interface. The advanced balloon overtube directly addresses the need to maximize complete colonoscopies for better patient health, using a cost effective endoscopy accessory that is easy to use and time efficient. This novel approach provides a new way of converting incomplete procedures to completed procedures to minimize costs while improving patient outcomes and overall clinical experiences. The technological expertise that will be generated during this project will address a critical unmet need in the colonoscopy market, while future versions may be transferable to other fields of use in the medical procedure realm.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.