Abstract
Background
Although magnetic endoscope imaging of the colonoscope via the Endoscope Positioning Detecting Unit (EPDU) has been studied to some extent in Europe, its application in the United States has been limited. The purposes of this study were to determine whether the technique enabled for accurate localization of the lesion and to determine if and how the device facilitated scope insertion and completion of the colonoscopic exam.
Methods
Outpatient colonoscopies using the EPDU were performed by three experienced surgical endoscopists over a 5-month period. A specialized scope with electromagnetic coils or a regular scope with a magnetic probe insert in the instrument channel was used for the duration of the examination to identify loops and localize pathology.
Results
A total of 80 colonoscopies were performed with the device. In two patients, the probe insert was removed prior to completion of the procedure; thus, the total number of examinations included in the study was 78. The EPDU was used in conjunction with transillumination to estimate the location of polyps or cancers in the 33 patients (42%) in whom such lesions were found. In the four patients who subsequently underwent operation, the lesion’s location as estimated by EPDU was verified. In regard to the usefulness of the device during insertion, the EPDU led to the discovery of loops and to the application of pressure that resulted in prompt completion of the examination in 28% of cases (deemed most useful). In 33% of cases, the device identified loops and led to the application of abdominal wall pressure and early position changes, thus facilitating the examination; however it did not lead to its immediate or rapid completion. In 39% of cases, the device was not required or used for insertion due to the simple nature of the examination.
Conclusions
The EPDU was accurate in estimating lesion location. The device also holds promise as an aid in the completion of difficult exams (about 30% of cases in this study).
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References
IJ Adam Z Ali AJ Shorthouse (2001) ArticleTitleInadequacy of colonoscopy revealed by three-dimensional electromagnetic imaging Dis Colon Rectum 44 978–983 Occurrence Handle11496078
WC Cirocco LC Rusin (1991) ArticleTitleDocumenting the use of fluoroscopy during colonoscopic examination: a prospective study Surg Endosc 4 200–203
WC Cirocco LC Rusin (1993) ArticleTitleThe reliability of cecal landmarks during colonoscopy Surg Endosc 7 33–36 Occurrence Handle10.1007/BF00591234 Occurrence Handle8424231
WC Cirocco LC Rusin (1996) ArticleTitleFluoroscopy: a valuable ally during difficult colonoscopy Surg Endosc 10 1080–1084 Occurrence Handle10.1007/s004649900244 Occurrence Handle8881056
W Dickey KG Porter (1996) ArticleTitleAir contrast fluoroscopy as a diagnostic aid during colonoscopy Endoscopy 28 730
CS McArthur S Royaie JD Waye (1999) ArticleTitleSafety of preoperation endoscopic tattoo with India ink for identification of colonic lesions Surg Endosc 13 397–400 Occurrence Handle10.1007/s004649900997 Occurrence Handle10094755
M Montorsi E Opocher R Santambrogio P Bianchi C Faranda P Arcidiacono GR Passoni et al. (1999) ArticleTitleOriginal technique for small colorectal tumor localization during laparoscopic surgery Dis Colon Rectum 42 819–822 Occurrence Handle10378609
Olympus Optical. The endoscope position detecting unit, Olympus UPD, Evis Exera Colonovideoscope, Olympus CF Type Q160DL. Tokyo, Olympus Optical
BP Saunders GD Bell CB Williams JS Bladen AP Anderson (1995) ArticleTitleFirst clinical results with a real time, electronic imager as an aid to colonoscopy Gut 36 913–917 Occurrence Handle7615283
SG Shah BP Saunders JC Brooker CB Williams (2000) ArticleTitleMagnetic imaging of colonoscopy: an audit of looping, accuracy and ancillary maneuvers Gastrointest Endosc 52 1–8 Occurrence Handle10.1067/mge.2000.107296 Occurrence Handle10882954
SG Shah JC Brooker CB Williams C Thapar BP Saunders (2000) ArticleTitleEffect of magnetic endoscope imaging on colonoscopy performance: a randomized controlled trial Lancet 356 1718–1722 Occurrence Handle10.1016/S0140-6736(00)03205-0 Occurrence Handle11095259
SG Shah JC Brooker C Thapar CB Williams BP Saunders (2002) ArticleTitlePatient pain during colonoscopy: an analysis using real-time magnetic endoscope imagine Endoscopy 6 435–440 Occurrence Handle10.1055/s-2002-31995
SG Shag JC Brooker CB Williams C Thapar N Suzuki BP Saunders (2002) ArticleTitleThe variable stiffness colonoscope: assessment of efficacy by magnetic endoscope imaging Gastrointest Endosc 56 195–201 Occurrence Handle10.1067/mge.2002.126062 Occurrence Handle12145596
SG Shah S Thomas-Gibson JC Brooker N Suzuki CB Williams C Thapar BP Saunders (2002) ArticleTitleUse of video and magnetic endoscope imaging for rating competence at colonoscopy: validation of a measurement tool Gastrointest Endosc 56 568–573 Occurrence Handle10.1067/mge.2002.128133 Occurrence Handle12297780
SG Shag HG Pearson S Moss E Kweka PK Jalal BP Saunders (2002) ArticleTitleMagnetic endoscope imaging: a new technique for localizing colonic lesions Endoscopy 34 900–904 Occurrence Handle10.1055/s-2002-35297 Occurrence Handle12430075
SG Shah S Thomas-Gibson M Lockett JC Brooker CJ Thapar I Grace BP Saunders (2003) ArticleTitleEffect of real-time magnetic endoscope imaging on the teaching and acquisition of colonoscopy skills: results from a single trainee Endoscopy 35 421–425 Occurrence Handle10.1055/s-2003-38770 Occurrence Handle12701015
CB Williams BP Saunders GD Bell JS Bladen DF Sillies CM Guy (1997) ArticleTitleReal-time magnetic three-dimensional imaging of flexible endoscopy Gastrointest Endosc Clin North Am 7 469–475
Acknowledgement
This study was partially funded by an educational grant from Olympus Optical Co., Ltd., Tokyo, Japan.
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Ambardar, S., Arnell, T.D., Whelan, R.L. et al. A preliminary prospective study of the usefulness of a magnetic endoscope locating device during colonoscopy. Surg Endosc 19, 897–901 (2005). https://doi.org/10.1007/s00464-004-8948-0
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DOI: https://doi.org/10.1007/s00464-004-8948-0