title: Characterization of forces applied by endoscopists during colonoscopy by using a wireless colonoscopy force monitor.
abstract: BACKGROUND
  To perform a colonoscopy, the endoscopist maneuvers the colonoscope through a series of loops by applying force to the insertion tube. Colonoscopy insertion techniques are operator dependent but have never been comprehensively quantified.
  
  
  OBJECTIVE
  To determine whether the Colonoscopy Force Monitor (CFM), a device that continually measures force applied to the insertion tube, can identify different force application patterns among experienced endoscopists.
  
  
  METHODS
  Observational study of 6 experienced endoscopists performing routine diagnostic and therapeutic colonoscopy in 30 patients.
  
  
  METHODS
  Outpatient ambulatory endoscopy center.
  
  
  METHODS
  Adult male and female patients between 30 and 75 years of age undergoing routine colonoscopy.
  
  
  METHODS
  CFM monitoring of force applied to the colonoscope insertion tube during colonoscopy.
  
  
  METHODS
  Maximum and mean linear and torque force, time derivative of force, combined linear and torque vector force, and total manipulation time.
  
  
  RESULTS
  The CFM demonstrates differences among endoscopists for maximum and average push/pull and mean torque forces, time derivatives of force, combined push/torque force vector, and total manipulation time. Endoscopists could be grouped by force application patterns.
  
  
  CONCLUSIONS
  Only experienced endoscopists using conscious sedation in the patients were studied. Sample size was 30 patients.
  
  
  CONCLUSIONS
  This study demonstrates that CFM allows continuous force monitoring, characterization, and display of similarities and differences in endoscopic technique. CFM has the potential to facilitate training by enabling trainees to assess, compare, and quantify their techniques and progress.
authors.affiliation: Chevy Chase Clinical Research, Chevy Chase, MD, USA. louis.korman@verizon.net
authors.forename: Louis Y
authors.initials: LY
authors.lastname: Korman
authors.forename: Vladimir
authors.initials: V
authors.lastname: Egorov
authors.forename: Sergey
authors.initials: S
authors.lastname: Tsuryupa
authors.forename: Brendan
authors.initials: B
authors.lastname: Corbin
authors.forename: Mary
authors.initials: M
authors.lastname: Anderson
authors.forename: Noune
authors.initials: N
authors.lastname: Sarvazyan
authors.forename: Armen
authors.initials: A
authors.lastname: Sarvazyan
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D015331:Cohort Studies; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010147:Pain Measurement; D011312:Pressure; D011336:Probability; D013314:Stress, Mechanical