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

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.

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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

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

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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.

Corresponding author

Correspondence to Antonello Trecca.

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

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Trecca, A., Catalano, F., Bella, A. et al. Robotic colonoscopy: efficacy, tolerability and safety. Preliminary clinical results from a pilot study. Surg Endosc 34, 1442–1450 (2020). https://doi.org/10.1007/s00464-019-07332-6

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Keywords

  • Robotic colonoscopy
  • Adenoma detection rate
  • Colonoscopy
  • Colorectal cancer
  • Screening
  • Painless colonoscopy