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Clinical application of a new colonoscope with variable insertion tube rigidity: a pilot study
Authors:Sorbi D  Schleck C D  Zinsmeister A R  Gostout C J
Institution:Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, and Section of Biostatistics, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Abstract:BACKGROUND: Colonic loop formation can prolong colonoscopy, increase patient discomfort, and preclude complete examination. A colonoscope with variable insertion tube rigidity may facilitate colonoscopy. Our aim was to determine whether the use of a colonoscope with variable insertion tube rigidity reduces insertion time and improves patient acceptance of colonoscopy. METHODS: Fifty patients were randomly assigned to undergo colonoscopy with a conventional colonoscope or a variable rigidity colonoscope (VRC). Patient acceptance, dosage of medication, use of abdominal pressure, and patient repositioning were assessed. Statistical analysis was performed by the 2-sample Wilcoxon rank sum test and an extension of Fisher exact test. RESULTS: The groups were comparable with respect to age, gender, and medications required during colonoscopy. The cecum was reached in all 25 patients who underwent colonoscopy with the VRC, including 1 patient in whom the cecum was not reached at a previous colonoscopy with a conventional instrument. In the conventional colonoscopy group, the cecum was not reached in 4 patients (2 poor preparation, 2 loop formation). There was no significant difference between the 2 groups with respect to insertion time. In the group that underwent colonoscopy with the variable rigidity instrument, less abdominal pressure was required (p = 0.05), and nursing assessment of patient discomfort was more favorable (p = 0.05). There were no complications and no significant differences in the intubation time to cecum or in repositioning, patient acceptance, or patient assessment of abdominal pain. CONCLUSION:The use of a variable rigidity colonoscope reduced the frequency of abdominal pressure but did not affect intubation time to cecum, repositioning, patient acceptance, or patient assessment of abdominal pain.
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