Application of navigation system in colonoscopy

Abstract

Introduction. There are opinions that the use of modern high-tech additional techniques, including a navigation system for positioning a colonoscope (MEI), can both increase the diagnostic efficiency of colonoscopy and its comfort for the patient, and do not affect the quality of colonoscopy. Aim. To determine the capabilities of MEI during colonoscopy without sedation. Materials and methods. The single-center, prospective, randomized study included 120 patients (from 20 to 82 years, mean age 51.8 years; 53% men / 47% women) who underwent routine diagnostic outpatient colonoscopy using a rotational technique by experienced endoscopists using MEI navigation system. The study took place in two stages: Stage 1 – randomization and assessment of group comparability (group 1 – MEI, n = 57 and group 2 – without MEI, n = 63); Stage 2 – determination of the number of patients with colon preparation for colonoscopy according to the Boston scale > 6 points (n = 112: 1st study-MEI group, n = 52 and 2nd control group, n = 60); comparative analysis between groups of the frequency of cecal intubation, time of cecal intubation, pain assessment on the VAS scale in cm. Statistical analysis was carried out using Fisher’s exact test, two-sided Mann-Whitney rank sum U test at a significance level of 0.05. Results and discussion. The groups were comparable in age, gender, preliminary indications for the study. The cecum was intubated significantly more often in group 1 (100% vs 90%, p < 0.05). There was no significant difference in the time required for cecal intubation (p = 0.258) and the difference in the mean time required for cecal intubation was 22 seconds. The VAS pain assessment also did not reveal significant differences (p = 1.023). We determined that the increase in the frequency of cecal intubation using MEI by experienced endoscopists increases by 10% and reaches 100%, while the opinion about reducing the time of cecal intubation and improving patient comfort were not confirmed. Conclusion. MEI during rotational colonoscopy performed by experienced endoscopists increases the likelihood of cecal intubation during routine colonoscopy by 10%. MEI does not increase the time required for cecal intubation and is not associated with the frequency or intensity of pain or discomfort on the VAS scale in colonoscopy without sedation.

Keywords

• colonoscopy
• colonoscope positioning system
• navigation colonoscopy
• pain assessment
• sedation