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Does use of a colonoscopy imaging device improve performance? A cohort study

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Abstract

Background

Magnetic endoscopic imagers (MEIs) are being introduced during colonoscopy, principally for training. They aid recognition and resolution of loops. This has potential to improve technique resulting in increased completion rates and better patients’ experience.

Objective

To determine whether the use of a MEI improves colonoscopists’ performance.

Design

Cohort study.

Settings

Endoscopy unit in a district general hospital.

Patients

Consecutive patients undergoing colonoscopy during a 33 month period were studied.

Intervention

Patients underwent colonoscopy with or without the use of a magnetic endoscopic imager.

Main outcome measures

Patient comfort and colonoscopy completion rates with and without the use of a magnetic endoscopic imager. Other data recorded included sedation and analgesia doses, patient age and gender, bowel preparation quality, antispasmodic dose, time of day, and consciousness level.

Results

A total of 5,879 colonoscopies were performed. A magnetic endoscopic imager was used for 4,873. A greater proportion of patients in the imager group had the lowest discomfort score (56.2 vs. 39.8 %, logistic regression; p = 0.005). Doses of midazolam were similar in both groups (1.93 vs. 2.14 mg for imager and nonimager groups respectively). Completion rates were 94.5 % with an imager and 91 % without (logistic regression; p = 0.088). Logistic regression analysis showed that buscopan improved completion rate but detrimental factors included increasing patient age, discomfort, poor bowel preparation, and an afternoon procedure. Factors not influencing completion included gender, sedation and analgesia doses, and consciousness level. There was no correlation between documented reason for failure and use of the imager.

Limitations

This was a nonrandomized trial although improved with logistic regression analysis.

Conclusions

Magnetic endoscopic imager use improves patient comfort during colonoscopy but has not been shown to improve completion.

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Disclosures

Mr. Wood, Mr. Foy, Dr. Valori, Miss Lucarotti, Mr. Fowler, Mr. Dowler, and Mr. Cook have no conflict of interest or financial ties to disclose.

Funding

Nil.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Gloucestershire Royal Hospital, Gloucester, GL1 3NN, UK

    James J. Wood, Michelle E. Lucarotti, Aidan L. Fowler & Timothy A. Cook

  2. South West Research Design Service, Gloucestershire Royal Hospital, Gloucester, GL1 3NN, UK

    Christopher J. W. Foy

  3. Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, GL1 3NN, UK

    Roland Valori

  4. Department of Endoscopy, Gloucestershire Royal Hospital, Gloucester, GL1 3NN, UK

    Kevin Dowler

Authors
  1. James J. Wood
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  2. Christopher J. W. Foy
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  3. Roland Valori
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  4. Michelle E. Lucarotti
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  5. Aidan L. Fowler
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  6. Kevin Dowler
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  7. Timothy A. Cook
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Corresponding author

Correspondence to James J. Wood.

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Wood, J.J., Foy, C.J.W., Valori, R. et al. Does use of a colonoscopy imaging device improve performance? A cohort study. Surg Endosc 26, 3616–3621 (2012). https://doi.org/10.1007/s00464-012-2384-3

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  • DOI: https://doi.org/10.1007/s00464-012-2384-3

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