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Robotic colonoscopy: efficacy, tolerability and safety. Preliminary clinical results from a pilot study

  • Antonello TreccaEmail author
  • Filippo Catalano
  • Antonino Bella
  • Raffaele Borghini
New Technology
  • 16 Downloads

Abstract

Background

Robotic colonoscopy (RC) is a pneumatically-driven self-propelling platform (Endotics System®) able to investigate the colon, in order to reduce pain and discomfort. Aims: (1) to describe the progress in gaining experience and skills of a trainee in RC; (2) to show the clinical outcomes of RC.

Methods

Pilot study. An experienced endoscopist started a training on RC whose progress was assessed comparing the results of 2 consecutive blocks of 27 (Group A) and 28 (Group B) procedures. CIR (Cecal Intubation Rate), CIT (Cecal Intubation Time) and Withdrawal Time (WT) were measured. Polyp Detection Rate (PDR), Adenoma Detection Rate (ADR) and Advanced Neoplasia Detection Rate (ANDR) were calculated. Possible adverse events were recorded. At the end of the procedure all patients completed a visual analog scale (VAS) to measure their perceived pain during RC and reported their willingness to repeat RC.

Results

General CIR was 92.7%, reaching 100% in Group B. Comparing the two groups, CIT significantly decreased from 55 to 22 min (p value 0.0007), whereas procedures with CIT ≤ 20 min increased (p value 0.037). WT significatively reduced from 21 to 16 min (p value 0.0186). PDR was 40% (males 62.5%, females 14.3%). ADR was 26.7% (males 27.5%, females 14.3%). Most of patients judged the procedure as mild or no distress, with high willingness-to-repeat the RC (92.7%).

Conclusions

Our results about RC are encouraging as preliminary experience, with clear individual learning progress, accurate diagnosis in a painless or comfortable procedure and with possibility to remove polypoid lesions. Studies with larger populations are needed to confirm obtained results.

Keywords

Robotic colonoscopy Adenoma detection rate Colonoscopy Colorectal cancer Screening Painless colonoscopy 

Abbreviations

ADNR

Advanced neoplasia detection rate

ADR

Adenoma detection rate

BBPS

Boston bowel preparation scale

CC

Conventional colonoscopy

CIR

Cecal intubation rate

CIT

Cecal intubation time

EMR

Endoscopic mucosal resection

IQR

Interquartile range

PDR

Polyp detection rate

RC

Robotic colonoscopy

SAEs

Serious adverse events

SE

Standard error

WT

Withdrawal time

Notes

Author Contributions

AT conceived and designed the study. AT and RB drafted the manuscript with critical revisions and contributed to the acquisition of the data. FC contributed to the acquisition of data. AB contributed to statistical analysis. All authors contributed to the analysis and interpretation of data. All authors approved the final version of the manuscript. AT is the author who is acting as the submission's guarantor.

Funding

No institutional, private or corporate financial support for the work was received.

Compliance with ethical standards

Disclosures

Antonello Trecca, Filippo Catalano, Antonino Bella and Raffaele Borghini have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary file1 (MP4 192114 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Operative EndoscopyProgetto I-SalusRomeItaly
  2. 2.Department of Emergency Surgical EndoscopyBorgo Trento HospitalVeronaItaly
  3. 3.Department of Infectious DiseasesIstituto Superiore di SanitàRomeItaly
  4. 4.Department of Translational and Precision MedicineSapienza UniversityRomeItaly

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