Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E537-E542
DOI: 10.1055/a-1352-3688
Original article

Feasibility study of a single-use balloon-assisted robotic colonoscope in healthy volunteers

Chi-Chung Foo
1   Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
,
Wai-Keung Leung
2   Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
,
Thomas Ka-Luen Lui
3   Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR
,
Jo Lai-Ken Cheung
4   Bio-Medical Engineering (HK) Limited, Hong Kong SAR
,
Kwok-Wai Lam
4   Bio-Medical Engineering (HK) Limited, Hong Kong SAR
5   Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
,
Biji Sreedhar
4   Bio-Medical Engineering (HK) Limited, Hong Kong SAR
,
Chung-Kwong Yeung
1   Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
4   Bio-Medical Engineering (HK) Limited, Hong Kong SAR
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Background and study aims Despite its widespread adoption, colonoscope still has its limitations. Advancement is often limited by the looping of colon. The isolation of SARS-CoV-2 in stool raises concern for the risk of disease transmission. A single-use robotic colonoscope, the NISInspire-C System, that features a balloon-suction anchorage mechanism was developed to address these.

Methods The NISInspire-C balloons are designed to provide anchorage for straightening of the colon during advancement. Angulation at the bending section is tendon-wire driven by servo mechanisms integrated into a robotic control console. This was a pilot, prospective trial to evaluate the safety and feasibility of this system. Healthy volunteers underwent examination with the NISInspire-C, followed by the conventional colonoscope. The procedure time, cecal intubation rates (CIR), complications, and level of pain were measured.

Results A total of 19 subjects underwent the examination. The cecal intubation rate was 89.5 % (17/19) and the overall time-to-cecum was 26.3 minutes (SD: 17.9 mins). There were no procedure-related complications. Polyps were detected in seven of 19 (36.8 %) subjects during the NISInspire-C procedure. Three more subjects were found to have adenomatous polyps with the conventional colonoscope. There was minimal variation in level of pain during the procedures with the two colonoscopes.

Conclusion The single-use robotic colonoscope NISInspire-C is a safe and feasible alternative to the conventional colonoscope. Further technical refinement is needed to improve the CIR. This study was limited by its small sample size.



Publication History

Received: 28 August 2020

Accepted: 30 November 2020

Article published online:
17 March 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2021; 53(05): 564-564
DOI: 10.1055/a-1373-8840

 

  • References

  • 1 González-Candelas F, Guiral S, Carbó R. et al. Patient-to-patient transmission of hepatitis C virus (HCV) during colonoscopy diagnosis. Virol J 2010; 7: 217
    CrossrefPubMedGoogle Scholar
  • 2 Kovaleva J, Peters FT, van der Mei HC. et al. Transmission of infection by flexible gastrointestinal endoscopy and bronchoscopy. Clin Microbiol Rev 2013; 26: 231-254
    CrossrefPubMedGoogle Scholar
  • 3 Lai EJ, Calderwood AH, Doros G. et al. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc 2009; 69: 620-625
    CrossrefPubMedGoogle Scholar
  • 4 Rex DK, Schoenfeld PS, Cohen J. et al. Quality indicators for colonoscopy. Gastrointest Endosc 2015; 81: 31-53
    CrossrefPubMedGoogle Scholar
  • 5 Yeung CK, Cheung JL, Sreedhar B. Emerging next-generation robotic colonoscopy systems towards painless colonoscopy. J Dig Dis 2019; 20: 196-205
    CrossrefPubMedGoogle Scholar
  • 6 Chanques G, Payen JF, Mercier G. et al. Assessing pain in non-intubated critically ill patients unable to self report: an adaptation of the Behavioral Pain Scale. Intensive Care Med 2009; 335: 2060-2067
    CrossrefPubMedGoogle Scholar
  • 7 Payen JF, Bru O, Bosson JL. et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001; 29: 2258-2263
    CrossrefPubMedGoogle Scholar
  • 8 Shergill AK, McQuaid KR. Ergonomic endoscopy: An oxymoron or realistic goal?. Gastrointest Endosc 2019; 90: 966-970
    CrossrefPubMedGoogle Scholar
  • 9 Ofstead CL, Wetzler HP, Heymann OL. et al. Longitudinal assessment of reprocessing effectiveness for colonoscopes and gastroscopes: Results of visual inspections, biochemical markers, and microbial cultures. Am J Infect Control 2017; 45: e26-e33
    CrossrefPubMedGoogle Scholar
  • 10 Neves MS, da Silva MG, Ventura GM. et al. Effectiveness of current disinfection procedures against biofilm on contaminated GI endoscopes. Gastrointest Endosc 2016; 83: 944-953
    CrossrefPubMedGoogle Scholar
  • 11 Ofstead CL, Heymann OL, Quick MR. et al. Residual moisture and waterborne pathogens inside flexible endoscopes: Evidence from a multisite study of endoscope drying effectiveness. Am J Infect Control 2018; 46: 689-696
    CrossrefPubMedGoogle Scholar
  • 12 Wang P, Xu T, Ngamruengphong S. et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut 2018; 67: 1626-1636
    CrossrefPubMedGoogle Scholar
  • 13 Lui RN, Wong SH, Sánchez-Luna SA. et al. Overview of guidance for endoscopy during the coronavirus disease 2019 pandemic. J Gastroenterol Hepatol 2020; 35: 749-759
    CrossrefPubMedGoogle Scholar