A UK single-center pilot experience using a novel robotic inchworm colonoscopy system.

Area of Science:

• Gastroenterology and Endoscopy
• Medical Robotics
• Patient Comfort and Safety

Background:

• Standard colonoscopy (SC) is the gold standard for lower gastrointestinal investigation but often causes pain and discomfort, even with sedation.
• Pain and technical challenges limit the effectiveness and completion rates of SC in some patients.
• Robotic technology offers a potential solution to improve patient experience and procedure success.

Purpose of the Study:

• To evaluate the feasibility and patient comfort of robotic colonoscopy (RC) in a UK National Health Service setting.
• To assess RC's effectiveness in patients with previously failed SC or those facing technical difficulties.
• To explore RC as a potential alternative to SC, allowing procedures outside traditional endoscopy units.

Main Methods:

• A pilot study conducted between January 2023 and August 2024 at a UK NHS Hospital.
• One expert endoscopist performed robotic colonoscopies (RC) on 93 patients with indications including rectal bleeding and failed SC.
• Procedures were performed in an outpatient clinical room setting, without sedation.

Main Results:

• Of 21 patients with failed SC, 14 (66%) successfully completed the procedure with RC.
• A significant reduction in patient discomfort was observed: SC (4.71) vs. RC (1.71; p < 0.001).
• Average cecal intubation time was 41.07 minutes, and total procedure time was 76.48 minutes.

Conclusions:

• Robotic colonoscopy (RC) provides a significantly more comfortable and potentially safer alternative to standard colonoscopy (SC).
• RC enables procedures like visualization, biopsy, and polypectomy without sedation, allowing outpatient settings.
• The study indicates a learning curve for reducing cecal intubation time while demonstrating RC's viability.