title: Clinical application of a new colonoscope with variable insertion tube rigidity: a pilot study.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, and Section of Biostatistics, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
authors.forename: D
authors.initials: D
authors.lastname: Sorbi
authors.forename: C D
authors.initials: CD
authors.lastname: Schleck
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: C J
authors.initials: CJ
authors.lastname: Gostout
mesh_terms: D000328:Adult; D000368:Aged; D020685:Colonoscopes; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies