Robotic Colonoscopy (original) (raw)
Related papers
2017
This chapter is focused on emerging robotic techniques for improving conventional colonoscopy. Video-colonoscopy is considered the gold-standard for the diagnosis of colonic diseases, and it is included as first line choice in colon-rectum cancer screening program in high-risk populations. However, this diagnostic technique shows some technical limitations, such as invasiveness and patient discomfort, which limit the adherence to the procedure. To facilitate the conventional colonoscopy procedure, robotic colonoscopy solutions have been proposed. State of the art of robotic colonoscopy has been thus summarized. In details, Endotics System and Invendoscope are presented. The Endotics System is composed of a disposable probe and a workstation. The probe has a steerable tip, a flexible body and a thin tail. The head hosts both a vision system and channels for water jet and air in order to provide rinsing and suction/insufflation, respectively. The workstation allows the endoscopist to ...
A novel self-propelled disposable colonoscope is effective for colonoscopy in humans (with video)
Gastrointestinal endoscopy, 2015
The self-propelled, disposable colonoscope (SPDC) with 360° view is designed to enhance visualization, minimize risks of perforation and infection transmission, and shorten operator training time associated with conventional colonoscopy (CC). We evaluated SPDC efficacy for cecal intubation and for safety. Prospective patients presenting for colorectal cancer screening underwent SPDC colonoscopy immediately followed by CC. Initial patients necessary for SPDC operators to achieve proficiency made up the "training cohort." Subsequent enrolled patients made up the "study cohort." SPDC colonoscopy was performed to the cecum, where anatomic landmarks were photographed and mucosal suction-marks placed. During SPDC withdrawal, polyps were recorded and similarly marked. At second-pass (using CC), any potential mucosal damage and suction-marks from the SPDC, as well as polyps, were recorded. Main endpoints included (1) SPDC cecal intubation rates, confirmed by anatomic lan...
Digestive and Liver Disease, 2013
Background: Despite colonoscopy represents the conventional diagnostic tool for colorectal pathology, its undeniable discomfort reduces compliance to screening programmes. Aims: To evaluate feasibility and accuracy of a novel robotically-driven magnetic capsule for colonoscopy as compared to the traditional technique. Methods: Eleven experts and eleven trainees performed complete colonoscopy by robotic magnetic capsule and by conventional colonoscope in a phantom ex vivo model (artificially clean swine bowel). Feasibility, overall accuracy to detect installed pins, procedure elapsed time and intuitiveness were measured for both techniques in both operator groups. Results: Complete colonoscopy was feasible in all cases with both techniques. Overall 544/672 pins (80.9%) were detected by experimental capsule procedure, while 591/689 pins (85.8%) were detected within conventional colonoscopy procedure (P = ns), thus establishing non-inferiority. With the experimental capsule procedure, experts detected 74.2% of pins vs. 87.6% detected by trainees (P < 0.0001). Overall time to complete colon inspection by robotic capsule was significantly higher than by conventional colonoscopy (556 ± 188 s vs. 194 ± 158 s, respectively; P = 0.0001). Conclusion: With the limitations represented by an ex vivo setting (artificially clean swine bowel and the absence of peristalsis), colonoscopy by this novel robotically-driven capsule resulted feasible and showed adequate accuracy compared to conventional colonoscopy.
The International journal of artificial organs, 2009
Currently, the best method for CRC screening is colonoscopy, which ideally (where possible) is performed under partial or deep sedation. This study aims to evaluate the efficacy of the Endotics System, a new robotic device composed of a workstation and a disposable probe, in performing accurate and well-tolerated colonoscopies. This new system could also be considered a precursor of other innovating vectors for atraumatic locomotion through natural orifices such as the bowel. The flexible probe adapts its shape to the complex contours of the colon, thereby exerting low strenuous forces during its movement. These novel characteristics allow for a painless and safe colonoscopy, thus eliminating all major associated risks such as infection, cardiopulmonary complications and colon perforation. An experimental study was devised to investigate stress pattern differences between traditional and robotic colonoscopy, in which 40 enrolled patients underwent both robotic and standard colonosco...
Frontiers of Robotic Colonoscopy: A Comprehensive Review of Robotic Colonoscopes and Technologies
Flexible colonoscopy remains the prime mean of screening for colorectal cancer (CRC) and the gold standard of all population-based screening pathways around the world. Almost 60% of CRC deaths could be prevented with screening. However, colonoscopy attendance rates are affected by discomfort, fear of pain and embarrassment or loss of control during the procedure. Moreover, the emergence and global thread of new communicable diseases might seriously affect the functioning of contemporary centres performing gastrointestinal endoscopy. Innovative solutions are needed: artificial intelligence (AI) and physical robotics will drastically contribute for the future of the healthcare services. The translation of robotic technologies from traditional surgery to minimally invasive endoscopic interventions is an emerging field, mainly challenged by the tough requirements for miniaturization. Pioneering approaches for robotic colonoscopy have been reported in the nineties, with the appearance of inchworm-like devices. Since then, robotic colonoscopes with assistive functionalities have become commercially available. Research prototypes promise enhanced accessibility and flexibility for future therapeutic interventions, even via autonomous or robotic-assisted agents, such as robotic capsules. Furthermore, the pairing of such endoscopic systems with AI-enabled image analysis and recognition methods promises enhanced diagnostic yield. By assembling a multidisciplinary team of engineers and endoscopists, the paper aims to provide a contemporary and highly-pictorial critical review for robotic colonoscopes, hence providing clinicians and researchers with a glimpse of the major changes and challenges that lie ahead.
The American Journal of Gastroenterology, 2007
OBJECTIVES: Unsedated colonoscopy is an uncomfortable procedure for most patients. Discomfort during colonoscopy is largely related to looping of the colonoscope, which displaces the colon from its native configuration and stretches attachments to the mesentery. A novel computer-assisted colonoscope utilizes a fully articulated, computer-controlled insertion tube. On manual insertion of the colonoscope, the position and angle of the scope's tip are encoded into a computer algorithm. As the colonoscope is advanced, the computer directs each successive segment to take the same shape that the tip had at a given insertion depth. The insertion tube thus changes its shape at different insertion depths in a "follow-the-leader" manner. METHODS: This initial clinical trial with this novel colonoscopy system was designed as a prospective, nonrandomized, unblinded, feasibility study. Three physicians of varying levels of experience participated in the study. RESULTS: Eleven consecutive patients (seven men, four women, age range 19-80) meeting inclusion criteria for screening or diagnostic colonoscopy were enrolled in the study. The cecum was reached in 10 consecutive patients (100%). Findings included diverticular disease in two cases and multiple colonic polyps in two cases. Postprocedure assessment at discharge, 48 h, and 30 days revealed no complications or adverse effects. Physician satisfaction and patient acceptance of this new technique were high. CONCLUSIONS: In this limited, first of its kind feasibility study, the computer-assisted colonoscope was shown to perform colonoscopy safely and effectively. The colonoscope's unique design limited loop formation during colonoscopy. Large-scale clinical trials are indicated.
An Automation Concept to Enhance Colonoscope Maneuverability
Sensors and Materials
Colonoscopy is the current gold standard for the visual diagnosis and treatment of colon-related health problems. However, the size of the colonoscope, combined with the nonautomatic nature of the device, can cause discomfort to patients during examination. To reduce the burden for patients and allow physicians to work more efficiently, an automated colonoscope concept is proposed. Fiber optic sensors mounted at the tip of the colonoscope measure the distance from the intestinal wall in two directions. The signals from these sensors are then fed into a control module to drive a motor-dial assembly that controls the movement of the tip of the colonoscope. Two DC motors connected to two rollers spinning in opposite directions automatically advance the colonoscope inside the colon. Results show that our automated colonoscope prototype is able to repeatedly advance inside a 100-cm-long in vitro simulation model in less than a minute without contacting the model wall.