Characterization of forces applied by endoscopists during colonoscopy by using a wireless colonoscopy force monitor.
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.
Korman
Louis Y
LY
Chevy Chase Clinical Research, Chevy Chase, MD, USA. louis.korman@verizon.net
Egorov
Vladimir
V
Tsuryupa
Sergey
S
Corbin
Brendan
B
Anderson
Mary
M
Sarvazyan
Noune
N
Sarvazyan
Armen
A
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