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Determining scope position during colonoscopy without use of ionizing radiation or magnetic imaging: the enhanced mapping ability of the NeoGuide Endoscopy System

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Abstract

Background

Knowledge of the position and shape of the endoscope could overcome many challenges of performing colonoscopy, e.g., loop formation. A novel computer-assisted colonoscope (NeoGuide Endoscopy System) delivers a real-time, three-dimensional map of the tip position and insertion tube shape in addition to the video image of the colon lumen. The aim of this study is to evaluate the mapping capabilities of the NeoGuide Endoscopy System in terms of colonic looping, insertion depth, tip position, and tip angle formation.

Methods

Ten endoscopists with various levels of experience were each shown 70 map images generated by the NeoGuide endoscopy system in a benchtop anatomical colon model. First endoscopists were asked to determine the tip angle based on the map image and the system’s corresponding tip positioning aid (20 images). In the second part they had to identify the scope-tip position in the colon model (40 images). In the third part ten images were presented for identification of colonic loops.

Results

The tip angle was correctly identified in 99% (198/200) of images. Using only the map images the scope position was accurately determined in 87.5% (350/400). Identification of colonic looping of the scope was appropriate in 99% (99/100). Overall accuracy was 92.4%, and overall positive predictive value was 94.9%.

Conclusion

Three-dimensional map images generated by the NeoGuide endoscopy system provide accurate information regarding tip position, insertion tube position, and colonic looping.

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References

  1. Cotton PB, Connor P, McGee D, Jowell P, Nickl N, Schutz S, Leung J, Lee J, Libby E (2003) Colonoscopy: practice variation among 69 hospital-based endoscopists. Gastrointest Endosc 57:352–357

    Article  PubMed  Google Scholar 

  2. Roberts-Thomson IC, Teo E (2009) Colonoscopy: art or science? J Gastroenterol Hepatol 24:180–184

    Article  PubMed  Google Scholar 

  3. Shah SG, Saunders BP, Brooker JC, Williams CB (2000) Magnetic imaging of colonoscopy: an audit of looping, accuracy and ancillary maneuvers. Gastrointest Endosc 52:1–8

    Article  CAS  PubMed  Google Scholar 

  4. Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP (2002) Patient pain during colonoscopy: an analysis using real-time magnetic endoscope imaging. Endoscopy 34:435–440

    Article  CAS  PubMed  Google Scholar 

  5. Leung FW (2008) Methods of reducing discomfort during colonoscopy. Dig Dis Sci 53:1462–1467

    Article  PubMed  Google Scholar 

  6. Rex DK, Khalfan HK (2005) Sedation and the technical performance of colonoscopy. Gastrointest Endosc Clin North Am 15:661–672

    Article  Google Scholar 

  7. Eickhoff A, Jakobs R, Kamal A, Mermash S, Riemann JF, van Dam J (2006) In vitro evaluation of forces exerted by a new computer-assisted colonoscope (the NeoGuide Endoscopy System). Endoscopy 38:1224–1229

    Article  CAS  PubMed  Google Scholar 

  8. Eickhoff A, van Dam J, Jakobs R, Kudis V, Hartmann D, Damian U, Weickert U, Schilling D, Riemann JF (2007) Computer-assisted colonoscopy (the NeoGuide Endoscopy System): results of the first human clinical trial (“PACE study”). Am J Gastroenterol 102:261–266

    Article  PubMed  Google Scholar 

  9. Shah SG, Brooker JC, Williams CB, Thapar C, Saunders BP (2000) Effect of magnetic endoscope imaging on colonoscopy performance: a randomised controlled trial. Lancet 356:1718–1722

    Article  CAS  PubMed  Google Scholar 

  10. Selehi S, Leung E, Wong L (2008) Factors affecting outcomes in colonoscopy. Gastroenterol Nurs 31:56–63

    Article  PubMed  Google Scholar 

  11. Ambardar S, Arnell TD, Whelan RL, Nihalani A, Forde KA (2005) A preliminary prospective study of the usefulness of a magnetic endoscope locating device during colonoscopy. Surg Endosc 19:897–901

    Article  CAS  PubMed  Google Scholar 

  12. Bell GD, Rowland RS, Rutter M, Abu-Sada M, Dogramadzi S, Allen C (1999) Colonoscopy aided by magnetic 3D imaging: assessing the routine use of a stiffening sigmoid overtube to speed up the procedure. Med Biol Eng Comput 37:605–611

    Article  CAS  PubMed  Google Scholar 

  13. Shah SG, Brooker JC, Thapar C, Suzuki N, Williams CB, Saunders BP (2002) Effect of magnetic endoscope imaging on patient tolerance and sedation requirements during colonoscopy: a randomized controlled trial. Gastrointest Endosc 55:832–837

    Article  PubMed  Google Scholar 

  14. Shah SG, Pearson HJ, Moss S, Kweka E, Jalal PK, Saunders BP (2002) Magnetic endoscope imaging: a new technique for localizing colonic lesions. Endoscopy 34:900–904

    Article  CAS  PubMed  Google Scholar 

  15. Shah SG, Saunders BP (2005) Aids to insertion: magnetic imaging, variable stiffness, and overtubes. Gastrointest Endosc Clin North Am 15:673–686

    Article  Google Scholar 

  16. Shah SG, Brooker JC, Williams CB, Thapar C, Suzuki N, Saunders BP (2002) The variable stiffness colonoscope: assessment of efficacy by magnetic endoscope imaging. Gastrointest Endosc 56:195–201

    Article  PubMed  Google Scholar 

  17. Dickey W (2004) Does fluoroscopic imaging still have a role in colonoscopy? J Clin Gastroenterol 38:676–679

    Article  PubMed  Google Scholar 

  18. Bladen JS, Anderson AP, Bell GD, Rameh B, Evans B, Heatley DJ (1993) Non-radiological technique for three-dimensional imaging of endoscopes. Lancet 341:719–722

    Article  CAS  PubMed  Google Scholar 

  19. Wolff WI, Shinya H (1971) Colonofiberoscopy. JAMA 217:1509–1512

    Article  CAS  PubMed  Google Scholar 

  20. Ginsberg GG (2003) Colonoscopy with the variable stiffness colonoscope. Gastrointest Endosc 58:579–584

    Article  PubMed  Google Scholar 

  21. Swain P (2005) Colonoscopy: new designs for the future. Gastrointest Endosc Clin North Am 15:839–863

    Article  Google Scholar 

  22. Waye JD (2000) Imaging of the colonoscope: magnetic, fluoroscopic, or neither? Gastrointest Endosc 52:131–133

    Article  CAS  PubMed  Google Scholar 

  23. Shah SG, Thomas-Gibson S, Lockett M, Brooker JC, Thapar CJ, Grace I, Saunders BP (2003) Effect of real-time magnetic endoscope imaging on the teaching and acquisition of colonoscopy skills: results from a single trainee. Endoscopy 35:421–425

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

This study was supported in part by NeoGuide Systems, Inc., Los Gatos, CA, USA.

Disclosures

Authors Johannes Striegel, Ralf Jakobs, Jacques Van Dam, Uwe Weickert, Jürgen F. Riemann, and Axel Eickhoff have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Medical Department C, Klinikum Ludwigshafen gGmbH, Bremserstrasse 79, 67063, Ludwigshafen, Germany

    Johannes Striegel, Ralf Jakobs, Uwe Weickert, Jürgen F. Riemann & Axel Eickhoff

  2. Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, USA

    Jacques Van Dam

Authors
  1. Johannes Striegel
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  2. Ralf Jakobs
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  3. Jacques Van Dam
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  4. Uwe Weickert
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  5. Jürgen F. Riemann
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  6. Axel Eickhoff
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Corresponding author

Correspondence to Johannes Striegel.

Additional information

Dr. Jacques Van Dam was temporary consultant for NeoGuide Endoscopy Systems.

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Striegel, J., Jakobs, R., Van Dam, J. et al. Determining scope position during colonoscopy without use of ionizing radiation or magnetic imaging: the enhanced mapping ability of the NeoGuide Endoscopy System. Surg Endosc 25, 636–640 (2011). https://doi.org/10.1007/s00464-010-1245-1

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  • DOI: https://doi.org/10.1007/s00464-010-1245-1

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