Editors' ChoiceMedical Devices

A self-propelled colon scope

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Science Translational Medicine  07 Oct 2015:
Vol. 7, Issue 308, pp. 308ec173
DOI: 10.1126/scitranslmed.aad3630

Colonoscopies remain one of the key clinical tools in managing bowel disease, assisting with everything from early detection of precancerous colorectal polyps to treatment of lower gastrointestinal bleeding to evaluation of diarrhea. For a complete study of the colon, the practitioner must reach the cecum (the beginning of the colon), but reaching the cecum reliably while completing the procedure safely and in a timely manner requires extensive training to avoid complications such as colonic perforation and transmission of infections from contaminated devices. Gluck and colleagues now report in a prospective human trial the safety and efficacy of a self-propelled and disposable colonoscope (SPDC), which represents a promising innovation to address some of the current challenges and risks associated with colonoscopy.

As a member of a family of devices in the area of “robotic endoscopes,” the SPDC consists of a pneumatic self-propulsion mechanism, which uses balloons and carbon dioxide for self-propulsion from the rectum toward the cecum, with significantly lower pressures exerted on colonic tissue than conventional colonoscopy, which could lower rates of perforation. The visualization system enabled 360° viewing of the colon. And the entire system is disposable, which should reduce infection transmission rates. Of the 56 subjects evaluated, cecal intubation was achieved in 55, and no mucosal damage was observed from the SPDC on follow-up conventional colonoscopy. Polyp detection with the SPDC was 87.5% of that observed by tandem conventional means. This first-in-human prospective study highlights the potential for robotic technologies to make routine gastrointestinal procedures easier to digest and could potentially also be applied to remote diagnostic and therapeutic endoscopic procedures, with the practitioner located in a different city, extending the reach of the gastrointestinal specialist.

N. Gluck et al., A novel self-propelled disposable colonoscope is effective for colonoscopy in humans (with video). Gastrointest. Endosc. 10.1016/j.gie.2015.08.083 (2015). [Abstract]

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