Feasibility of joystick guided colonoscopy

Abstract

The flexible endoscope is increasingly used to perform minimal invasive interventions. A novel add-on platform allows single-person control of both endoscope and instrument at the site of intervention. The setup changes the current routine of handling the endoscope. This study aims to determine if the platform allows effective and efficient manipulation to position the endoscope at potential intervention sites throughout the bowel. Five experts in flexible endoscopy first performed three colonoscopies on a computer simulator using the conventional angulation wheels. Next they trained with the joystick interface to achieve their personal level of intubation time with low pain score. 14 PhD students (novices) without hands-on experience performed the same colonoscopy case using either the conventional angulation wheels or joystick interface. Both novice groups trained to gain the average expert level. The cecal intubation time, pain score and visualization performance (% of bowel wall) were recorded. All experts reached their personal intubation time in 6 ± 6 sessions. Three experts completed their learning curve with low pain score in 8 ± 6 sessions. The novices required 11 ± 6 sessions using conventional angulation wheels, and 12 ± 6 sessions using the joystick interface. There was no difference in the visualization performance between the novice and between the expert groups. This study shows that the add-on platform enables endoscope manipulation required to perform colonoscopy. Experts need only a relatively short training period. Novices are as effective and as efficient in endoscope manipulation when comparing the add-on platform with conventional endoscope control.

Robotics and Artificial Intelligence in Gastrointestinal Endoscopy: Updated Review of the Literature and State of the Art

“…In a feasibility study on 22 subjects, cecal intubation was successful in 68% of cases in a median time of 21 (16-36) min [14]. When comparing the results obtained among experts and novices, no difference in the visualization performance was reported, whereas to reach their intubation time, experts required 6 ± 6 sessions, while novices required 12 ± 6 [15].…”

Feasibility of automated target centralization in colonoscopy

“…3 ). This interface has been validated before [ 11 , 24 – 26 ]. If a designated button was pressed and held on the joystick controller (arrow in Fig.…”

“…The robotic setup consisted of a conventional flexible endoscope with the handle linked to the steering module [ 21 , 24 ]. The handle and the steering module were suspended on a custom-designed holder.…”

Assessment of technical parameters and skills training to inform a simulation-based training program for semi-automated robotic colonoscopy

“…This may enable early diagnosis of colorectal pathology in primary care as a result of better engagement with patients. The robotic colonoscope (RC) is also designed have a more intuitive steering mechanism than standard colonoscopy, which may facilitate a more approachable diagnostic skill acquisition process for colonoscopists 8 and enable health professionals to make a diagnosis in the community or primary care setting.…”