The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase I project is the development of a functional prototype for a novel abdominal compression device that prevents endoscope looping during colonoscopy, a common complication that causes pain, procedure failure, and increased risk of bowel perforation. Looping is typically countered with manual application of external pressure to the abdomen by nurses, which is inconsistently effective and can lead to staff injury. This project proposes a novel compression device that provides a safe and effective alternative to manual abdominal pressure to improve colonoscopy outcomes. This Small Business Innovation Research (SBIR) Phase I project will address the technical challenges associated with engineering a colonoscopy compression device addressing the deficiencies of existing devices in patients with low body mass index (BMI) and low abdominal tissue volume. This project will accomplish this by first characterizing the differences in pressure applied by existing colonoscopy compression devices in high versus low BMI patients using pressure mapping. The results of this study will be utilized to design an adjustable and re-usable insert system that can be used during colonoscopy to apply different amounts of focused pressure. A prototype device will be produced and tested for localized pressure within a pressure range optimize to prevent looping in a low-BMI patient. 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.