Colonoscopy with robotic steering and automated lumen centralization: a feasibility study in a colon model

Abstract

Background and study aims: We introduced a new platform for performing colonoscopy with robotic steering and automated lumen centralization (RS-ALC) and evaluated its technical feasibility.

Participants and methods: Expert endoscopists (n = 8) and endoscopy-naive novices (n = 10) used conventional steering and RS-ALC to perform colonoscopy in a validated colon model with simulated polyps (n = 21). The participants were randomized to which modality they were to use first. End points were the cecal intubation time, number of detected polyps, and subjective evaluation of the platform.

Results: Novices were able to intubate the cecum faster with RS-ALC (median 8 minutes [min] 56 seconds [s], interquartile range [IQR] 6 min 46 s - 16 min 34 s vs. median 11 min 47 s, IQR 8 min 19 s - 15 min 33 s, P = 0.65), whereas experts were faster with conventional steering (median 2 min 9 s, IQR 1 min 13 s - 7 min 28 s vs. median 13 min 1 s, IQR 5 min 9 s - 16 min 54 s, P = 0.12). Novices detected more polyps with RS-ALC (median 88.1 %, IQR 79.8 % - 95.2 % vs. median 78.6 %, IQR 75.0 % - 91.7 %, P = 0.17), whereas experts detected more polyps with conventional steering (median 80.9 %, IQR 76.2 % - 85.7 % vs. median 69.0 %, IQR 61.0 % - 75.0 %, P = 0.03). Novices were more positive than experts about the new platform (P = 0.02), noting an easier and faster introduction of the colonoscope with RS-ALC than with conventional steering.

Conclusions: Colonoscopy with RS-ALC is technically feasible and appears to be easier and more intuitive than conventional steering for endoscopy-naive novices.