Characterization of forces applied by endoscopists during colonoscopy by using a wireless colonoscopy force monitor
Presented at Digestive Disease Week; May 30 to June 4, 2009, Chicago, Illinois (Gastrointest Endosc 2009;69:AB213-AB214).
Received 30 March 2009; accepted 27 August 2009. published online 18 November 2009.
Background
To perform a colonoscopy, the endoscopist maneuvers the colonoscope through a series of loops by applying force to the insertion tube. Colonoscopy insertion techniques are operator dependent but have never been comprehensively quantified.
Objective
To determine whether the Colonoscopy Force Monitor (CFM), a device that continually measures force applied to the insertion tube, can identify different force application patterns among experienced endoscopists.
Design
Observational study of 6 experienced endoscopists performing routine diagnostic and therapeutic colonoscopy in 30 patients.
Setting
Outpatient ambulatory endoscopy center.
Patients
Adult male and female patients between 30 and 75 years of age undergoing routine colonoscopy.
Interventions
CFM monitoring of force applied to the colonoscope insertion tube during colonoscopy.
Main Outcome Measurements
Maximum and mean linear and torque force, time derivative of force, combined linear and torque vector force, and total manipulation time.
Results
The CFM demonstrates differences among endoscopists for maximum and average push/pull and mean torque forces, time derivatives of force, combined push/torque force vector, and total manipulation time. Endoscopists could be grouped by force application patterns.
Limitations
Only experienced endoscopists using conscious sedation in the patients were studied. Sample size was 30 patients.
Conclusions
This study demonstrates that CFM allows continuous force monitoring, characterization, and display of similarities and differences in endoscopic technique. CFM has the potential to facilitate training by enabling trainees to assess, compare, and quantify their techniques and progress.
Current affiliations: Chevy Chase Clinical Research (L.Y.K., M.A.), Chevy Chase, Maryland, Artann Laboratories (V.E., S.T., B.C., N.S., A.S.), Trenton, New Jersey, USA
Reprint requests: Louis Y. Korman, MD, Chevy Chase Clinical Research, 5550 Friendship Blvd., Chevy Chase, MD 20815.
DISCLOSURE: Grant support from theNational Institute of Diabetes and Digestive and Kidney Diseasesgrant2R44 DK068936-02A1. The following authors disclosed financial relationships relevant to this publication: L. Y. Korman: Patent holder, Artann Laboratories; S. Tsuryupa: Patent holder and employee, Artann Laboratories; A. Sarvazyan: Patent holder and employee, Artann Laboratories; V. Egorov: Employee of Artann Laboratories; B. Corbin: Employee of Artann Laboratories; N. Sarvazyan: Employee of Artann Laboratories. M. Anderson disclosed no financial relationship relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr. Korman at louis.korman@verizon.net.
ABSTRACT