Segmental increases in force application during colonoscope insertion: quantitative analysis using force monitoring...

Area of Science:

• Gastroenterology
• Medical Device Technology
• Endoscopic Training

Background:

• Colonoscopy is a common procedure demanding significant skill.
• Understanding forces during colonoscopy is crucial for training and safety.

Purpose of the Study:

• To quantify forces on the colonoscope insertion tube during the procedure.
• To analyze force variations across different colonic segments.

Main Methods:

• An observational cohort study involving 7 expert and 9 trainee endoscopists.
• Forces were measured using a wireless colonoscopy force monitor attached to the insertion tube.
• 49 patients undergoing routine or diagnostic colonoscopies were included.

Main Results:

• Both axial and radial forces significantly increased from rectum to cecum.
• Operator-independent differences in forces were observed across colonic segments.
• Experts and trainees differed in specific force magnitudes and examination time.

Conclusions:

• Colonoscope insertion forces increase along the colonic path and are operator-independent.
• Findings highlight the physical demands of colonoscopy insertion.
• Further research is needed, considering study limitations like sample size and device prototype.