title: Segmental increases in force application during colonoscope insertion: quantitative analysis using force monitoring technology.
abstract: BACKGROUND
  Colonoscopy is a frequently performed procedure that requires extensive training and a high skill level.
  
  
  OBJECTIVE
  Quantification of forces applied to the external portion of the colonoscope insertion tube during the insertion phase of colonoscopy.
  
  
  METHODS
  Observational cohort study of 7 expert and 9 trainee endoscopists for analysis of colonic segment force application in 49 patients. Forces were measured by using the colonoscopy force monitor, which is a wireless, handheld device that attaches to the insertion tube of the colonoscope.
  
  
  METHODS
  Academic gastroenterology training programs.
  
  
  METHODS
  Patients undergoing routine screening or diagnostic colonoscopy with complete segment force recordings.
  
  
  METHODS
  Axial and radial force and examination time.
  
  
  RESULTS
  Both axial and radial force increased significantly as the colonoscope was advanced from the rectum to the cecum. Analysis of variance demonstrated highly significant operator-independent differences between segments of the colon (zones) in all axial and radial forces except average torque. Expert and trainee endoscopists differed only in the magnitude of counterclockwise force, average push/pull force rate used, and examination time.
  
  
  CONCLUSIONS
  Small study, observational design, effect of prototype device on insertion tube manipulation.
  
  
  CONCLUSIONS
  Axial and radial forces used to advance the colonoscope increase through the segments of the colon and are operator independent.
authors: Chevy Chase Clinical Research, Chevy Chase, Maryland 20815, USA. louis.korman@verizon.net
authors: Louis Y
authors: LY
authors: Korman
authors: Lawrence J
authors: LJ
authors: Brandt
authors: David C
authors: DC
authors: Metz
authors: Nadim G
authors: NG
authors: Haddad
authors: Stanley B
authors: SB
authors: Benjamin
authors: Susan K
authors: SK
authors: Lazerow
authors: Hannah L
authors: HL
authors: Miller
authors: David A
authors: DA
authors: Greenwald
authors: Sameer
authors: S
authors: Desale
authors: Milind
authors: M
authors: Patel
authors: Armen
authors: A
authors: Sarvazyan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D020685:Colonoscopes; D003113:Colonoscopy / Q000193:education / Q000295:instrumentation / Q000379:methods*; D004503:Education, Medical, Graduate; D006801:Humans; D016014:Linear Models; D055595:Mechanical Phenomena; D008875:Middle Aged; D013647:Task Performance and Analysis; D014481:United States