In vitro evaluation of forces exerted by a new computer-assisted colonoscope (the NeoGuide Endoscopy System)

Area of Science:

• Gastroenterology
• Medical Devices
• Endoscopy

Background:

• The NeoGuide Endoscopy System (NES) features a computer-controlled, articulated insertion tube designed to minimize scope displacement and looping during colonoscopy.
• Traditional colonoscopy can lead to looping and scope displacement, potentially causing patient discomfort.

Purpose of the Study:

• To evaluate the effectiveness of the NeoGuide Endoscopy System (NES) in reducing colon looping and forces during colonoscopy.
• To compare the NES with a standard colonoscope in terms of colonic displacement and forces exerted on the colon wall.

Main Methods:

• In vitro testing using a colon model with force transducers to measure axial forces.
• 10 gastroenterologists performed colonoscopies on a simulator using both the NES and a standard colonoscope.
• Colonic displacement was assessed by six independent gastroenterologists using a 0-5 scoring system.

Main Results:

• The NES demonstrated significantly lower axial forces at three of four measured flexure points (P < 0.05).
• Mean colonic displacement was significantly reduced with the NES (2.36) compared to the standard colonoscope (4.26) (P < 0.001).
• Moderate interobserver agreement was found for assessing colonic displacement due to looping (weighted kappa = 0.45, P < 0.01).

Conclusions:

• Colonoscopy performed with the NES resulted in significantly less looping and lower lateral force for advancement.
• The reduction in looping suggests the NES may decrease patient discomfort and the need for sedation during colonoscopy.