Introduction: Among the Gastrointestinal (GI) Endoscopy Editorial Board top 10 topics in advances in endoscopy in 2018, water exchange colonoscopy and artificial intelligence were both considered important advances in GI endoscopy. Artificial intelligence holds potential to increase and water exchange significantly increases adenoma detection.Areas covered: The authors searched MEDLINE (1998-2019) using the following medical subject terms and keywords: colonoscopy, adenoma, artificial intelligence, deep learning, computer-assisted detection, and neural networks. Additional related studies were manually searched from the reference lists of publications. Only fully published journal articles in English were reviewed. The latest date of the search was Aug 10, 2019.