EndoConf: real-time video consultation during endoscopy; telemedicine in endoscopy at its best

Abstract

Background and study aims The aim of this study was to introduce EndoConf, a reliable and easy-to-use tool capable of optimizing clinical care in endoscopy by reducing the number of repeat endoscopy procedures, providing continuous on-the-job clinical education, and allowing a smooth transition to the next level of artificial intelligence-supported systems.

Patients and methods We prospectively developed and improved a real-time conference system (EndoConf). EndoConf enables endoscopists to contact on-demand and in real time experienced endoscopists across other sites. After the initial introduction period, we registered all EndoConf-assisted procedures from our unit (Surgical Department of Odense University Hospital) over a 3-month period (Autumn of 2019).

Results Of 84 EndoConf-supported procedures, 58 were eligible for further analysis. Eventually, 38 calls were made, of which only four were technically of low quality (10.5 %) while three were not answered (7.9 %). Of the 35 (92.1 %) completed EndoConf calls; 24 were referred for endoscopic mucosal resection, six were referred for transanal microsurgery preceded by transrectal ultrasonography and three were referred for multidisciplinary conference, whereas in two cases, the lesion was resected during EndoConf.

Conclusions We found the EndoConf system to provide support that could reduce the number of unnecessary repeat endoscopic procedures while at the same time ensuring avoidance of any hazardous attempt at polypectomy.

Publication History

Received: 12 April 2021

Accepted: 02 July 2021

Article published online:
12 November 2021

• References

• 1 Schreuders EH, Ruco A, Rabeneck L. et al. Colorectal cancer screening: a global overview of existing programmes. Gut 2015; 64: 1637-1649
• 2 Kaminski MF, Thomas-Gibson S, Bugajski M. et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2017; 49: 378-397
• 3 Ferlitsch M, Moss A, Hassan C. et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49: 270-297
• 4 Peery AF, Cools KS, Strassle PD. et al. Increasing rates of surgery for patients with nonmalignant colorectal polyps in the United States. Gastroenterology 2018; 154: 1352-1360 e1353
• 5 Rutter MD, Jover R. Personalizing Polypectomy techniques based on polyp characteristics. Clin Gastroenterol Hepatol 2020; 18: 2859-2867
• 6 Subramaniam S, Bhandari P. Competency in polypectomy: when desirable becomes essential. Gastrointest Endosc 2018; 87: 645-647
• 7 Baatrup G, Buch N. Advanced adenomas and early colorectal cancers – SATC center (SATCC). A Danish initiative for the standardization and improvement of treatment of early, significant colorectal neoplasms. Acta Oncol 2019; 58: S1-S3
• 8 Porschmann C, Lubeck T, Arend JM. Impact of face masks on voice radiation. J Acoust Soc Am 2020; 148: 3663
• 9 Magee M, Lewis C, Noffs G. et al. Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols. J Acoust Soc Am 2020; 148: 3562
• 10 Vinsard DG, Mori Y, Misawa M. et al. Quality assurance of computer-aided detection and diagnosis in colonoscopy. Gastrointest Endosc 2019; 90: 55-63
• 11 Barua I, Vinsard DG, Jodal HC. et al. Artificial intelligence for polyp detection during colonoscopy: a systematic review and meta-analysis. Endoscopy 2021; 53: 277-284