Background and Study Aims: Considerable training is needed to enable endoscopists to use the currently available commercial colonoscopes and sigmoidoscopes effectively and safely. The aim of this study was to evaluate the safety and efficacy of the propulsion mechanism incorporated into the Aer-O-Scope® (GI View Ltd., Ramat Gan, Israel) - a novel self-propelled, self-navigating colonic endoscope for diagnostic purposes. Materials and Methods: Twenty young female pigs underwent complete bowel preparation followed by a sedated examination using the new device. Ten pigs underwent two consecutive procedures, with a wash-out period of 7 days between each procedure. The total number of procedures was 30. Two prototypes of the Aer-O-Scope, with different cable lengths and vehicle balloon sizes (n = 20 and n = 10 for prototypes I and II, respectively) were used. Each examination was followed by a standard colonoscopy for safety evaluation. The insertion length of the Aer-O-Scope was determined by fluoroscopy images.
Results: The colon was adequately clean in 25 procedures. Maximum insertion was achieved in 21 procedures (84 %) - 80 % with prototype I (n = 15) and 90 % with prototype II (n = 10). The time to maximum insertion averaged 8.9 ± 4.4 min (10 ± 4.6 and 6.6 ± 2.9 min for prototypes I and II; P < 0.05), and the withdrawal time averaged 3.4 ± 2.1 and 4.2 ± 3.4 min, respectively. The driving pressures for prototypes I and II averaged 46.3 and 34.5 mbar, respectively. The follow-up conventional colonoscopy identified no mucosal tears or perforations. Minor mucosal petechiae were noted in 43 % of the cases. No adverse events were noted up to 7 days after the procedure.
Conclusions: The propulsion mechanism used in this novel self-propelled, self-navigating colonoscope was effective and safe in pigs.
References
1
Rex D K, Johnson D A, Lieberman D A. et al .
Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology.
Am J Gastroenterol.
2000;
95
868-877
2
Gatto N M, Frucht H, Sundararajan V. et al .
Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study.
J Natl Cancer Inst.
2003;
95
230-236
5 Manciassi A, Park H, Lee S. et al .Robotic solutions and mechanisms for a semi-autonomous endoscope. Proceedings of the 2002 IEEE/RSJ International Conference on Intelligent Robots and Systems. Lausanne, Switzerland; EPFL 2002
6
Shike M, Repici A, Cohen L B. et al .
Major advances in colonoscopic technology: the ColonoSight®, a pull-power assisted disposable, non fiber-optic colonoscope.
Gastrointest Endosc.
2004;
59
AB113
8
Wexner S D, Garbus J E, Singh J J.
SAGES Colonoscopy Study Outcomes Group. A prospective analysis of 13 580 colonoscopies. Reevaluation of credentialing guidelines.
Surg Endosc.
2001;
15
251-261
9
Bowles C J, Leicester R, Romaya C, Swarbrick E, Williams C B, Epstein O A.
A prospective study of colonoscopy practice in the UK today: are we adequately prepared for national colorectal cancer screening tomorrow?.
Gut.
2004;
53
277-283
10
Ball E J, Osbourne J, Jowett S, Pellen M, Welfare M R.
Quality improvement programme to achieve acceptable colonoscopy completion rates: prospective before and after study.
BMJ.
2004;
329
665-667
11
Sumananc K, Zeralley I, Fox B M. et al .
Minimizing postcolonoscopy abdominal pain by using CO2 insufflations: a prospective, randomized, double blind, controlled trial evaluating a new commercially available CO2 delivery system.
Gastrointest Endosc.
2002;
56
190-194
15
Vucelic B, Rex D, Pulanic R. et al .
The Aer-O-Scope: proof of concept of a pneumatic, skill independent, self propelling, self navigating colonoscope.
Gastroenterology.
2006;
[in press]
