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.
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.
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%).
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.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Advanced neoplasia detection rate
Adenoma detection rate
Boston bowel preparation scale
Cecal intubation rate
Cecal intubation time
Endoscopic mucosal resection
Polyp detection rate
Serious adverse events
Centers for Disease Control and Prevention (CDC) (2013) Vital signs: colorectal cancer screening test use–United States, 2012 MMWR. Morb Mortal Wkly Rep 62:881–888
Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF et al (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329:1977–1981
Rex DK, Schoenfeld PS, Cohen J, Pike IM, Adler DG, Fennerty MB, Lieb JG 2nd, Park WG, Rizk MK, Sawhney MS, Shaheen NJ, Wani S, Weinberg DS (2015) Quality indicators for colonoscopy. Gastrointest Endosc 81:31–53
Strum WB (2016) Colorectal adenomas. N Engl J Med 375:389–390
Asfaha S, Alqahtani S, Hilsden RJ, MacLean AR, Beck PL (2008) Assessment of endoscopic training of general surgery residents in a North American health region. Gastrointest Endosc 68:1056–1062
Anderson JC, Butterly LF (2015) Colonoscopy: quality indicators. Clin Transl Gastroenterol 26(6):e77
No authors listed (1998) Guidelines for credentialing and granting privileges for gastrointestinal endoscopy. American Society for Gastrointestinal Endoscopy. Gastrointest Endosc 48:679–682
Lieberman DA, Faigel DO, Logan JR, Mattek N, Holub J, Eisen G, Morris C, Smith R, Nadel M (2009) Assessment of the quality of colonoscopy reports: results from a multicenter consortium. Gastrointest Endosc 69:645–653
Bianchi F, Ciuti G, Koulaouzidis A, Arezzo A, Stoyanov D, Schostek S, Oddo CM, Menciassi A, Dario P (2017) An innovative robotic platform for magnetically-driven painless colonoscopy. Ann Transl Med 5:421
Tumino E, Sacco R, Bertini M, Bertoni M, Parisi G, Capria A (2010) Endotics system vs colonoscopy for the detection of polyps. World J Gastroenterol 16:5452–5456
Tumino E, Parisi G, Bertoni M, Bertini M, Metrangolo S, Ierardi E, Cervelli R, Bresci G, Sacco R (2017) Use of robotic colonoscopy in patients with previous incomplete colonoscopy. Eur Rev Med Pharmacol Sci 21:819–826
World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191–2194
Lin OS (2017) Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction. Intest Res 15:456–466
ASGE Standards of Practice Committee, Early DS, Lightdale JR, Vargo JJ 2nd, Acosta RD, Chandrasekhara V, Chathadi KV, Evans JA, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Muthusamy VR, Pasha SF, Saltzman JR, Shergill AK, Cash BD, DeWitt JM (2018) Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc 87:327–337
No authors listed (2003) The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon. Gastrointest Endosc 58:S3–S43
Dixon MF (2002) Gastrointestinal epithelial neoplasia: Vienna revisited. Gut 51:130–131
Coe SG, Crook JE, Diehl NN, Wallace MB (2013) An endoscopic quality improvement program improves detection of colorectal adenomas. Am J Gastroenterol 108:219–26 (quiz 227)
ASGE Standards of Practice Committee, Fisher DA, Maple JT, Ben-Menachem T, Cash BD, Decker GA, Early DS, Evans JA, Fanelli RD, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Malpas PM, Sharaf RN, Shergill AK, Dominitz JA (2011) Complications of colonoscopy. Gastrointest Endosc 74:745–752
Cosentino F, Tumino E, Passoni GR, Morandi E, Capria A (2009) Functional evaluation of the endotics system, a new disposable self-propelled robotic colonoscope: in vitro tests and clinical trial. Int J Artif Organs 32:517–527
Hoff G, Holme Ø, Bretthauer M, Sandvei P, Darre-Næss O, Stallemo A, Wiig H, Høie O, Noraberg G, Moritz V, de Lange T (2017) Cecum intubation rate as quality indicator in clinical versus screening colonoscopy. Endosc Int Open 5:E489–E495
ASGE Quality Assurance in Endoscopy Committee, Calderwood AH, Day LW, Muthusamy VR, Collins J, Hambrick RD III, Brock AS, Guda NM, Buscaglia JM, Petersen BT, Buttar NS, Khanna LG, Kushnir VM, Repaka A, Villa NA, Eisen GM (2018) ASGE guideline for infection control during GI endoscopy. Gastrointest Endosc 87:1167–1179
Kenters N, Tartari E, Hopman J, El-Sokkary RH, Nagao M, Marimuthu K, Vos MC, ISAC working group, Huijskens EGW, Voss A (2018) Worldwide practices on flexible endoscope reprocessing. Antimicrob Resist Infect Control 7:153
Groth S, Krause H, Behrendt R, Hill H, Börner M, Bastürk M, Plathner N, Schütte F, Gauger U, Riemann JF, Altenhofen L, Rösch T (2012) Capsule colonoscopy increases uptake of colorectal cancer screening. BMC Gastroenterol 12:80
Obaro AE, Burling DN, Plumb AA (2018) Colon cancer screening with CT colonography: logistics, cost-effectiveness, efficiency and progress. Br J Radiol 91:20180307
Mohankumar D, Garner H, Ruff K, Ramirez FC, Fleischer D, Wu Q, Santello M (2014) Characterization of right wrist posture during simulated colonoscopy: an application of kinematic analysis to the study of endoscopic maneuvers. Gastrointest Endosc 79:480–489
Yung DE, Banfi T, Ciuti G, Arezzo A, Dario P, Koulaouzidis A (2017) Musculoskeletal injuries in gastrointestinal endoscopists: a systematic review. Expert Rev Gastroenterol Hepatol 11:939–947
Gluck N, Melhem A, Halpern Z, Mergener K, Santo E (2016) A novel self-propelled disposable colonoscope is effective for colonoscopy in humans (with video). Gastrointest Endosc 83:998–1004.e1
Kim HG (2016) Painless colonoscopy: available techniques and instruments. Clin Endosc 49:444–448
Yang YL, Li SS, Wang XB, Li JN (2018) Painless colonoscopy: a pilot study of a 5.9-mm endoscope for routine colonoscopy. Chin Med J (Engl) 131:857–858
No institutional, private or corporate financial support for the work was received.
Antonello Trecca, Filippo Catalano, Antonino Bella and Raffaele Borghini have no conflicts of interest or financial ties to disclose.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
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
- Robotic colonoscopy
- Adenoma detection rate
- Colorectal cancer
- Painless colonoscopy