title: Colonoscopy with robotic steering and automated lumen centralization: a feasibility study in a colon model.
abstract: OBJECTIVE
  We introduced a new platform for performing colonoscopy with robotic steering and automated lumen centralization (RS-ALC) and evaluated its technical feasibility.
  
  
  METHODS
  Expert endoscopists (n = 8) and endoscopy-naive novices (n = 10) used conventional steering and RS-ALC to perform colonoscopy in a validated colon model with simulated polyps (n = 21). The participants were randomized to which modality they were to use first. End points were the cecal intubation time, number of detected polyps, and subjective evaluation of the platform.
  
  
  RESULTS
  Novices were able to intubate the cecum faster with RS-ALC (median 8 minutes [min] 56 seconds [s], interquartile range [IQR] 6  min 46  s - 16  min 34  s vs. median 11  min 47  s, IQR 8  min 19  s - 15  min 33  s, P = 0.65), whereas experts were faster with conventional steering (median 2  min 9  s, IQR 1  min 13 s - 7  min 28  s vs. median 13  min 1  s, IQR 5  min 9 s - 16  min 54  s, P = 0.12). Novices detected more polyps with RS-ALC (median 88.1 %, IQR 79.8 % - 95.2 % vs. median 78.6 %, IQR 75.0 % - 91.7 %, P = 0.17), whereas experts detected more polyps with conventional steering (median 80.9 %, IQR 76.2 % - 85.7 % vs. median 69.0 %, IQR 61.0 % - 75.0 %, P = 0.03). Novices were more positive than experts about the new platform (P = 0.02), noting an easier and faster introduction of the colonoscope with RS-ALC than with conventional steering.
  
  
  CONCLUSIONS
  Colonoscopy with RS-ALC is technically feasible and appears to be easier and more intuitive than conventional steering for endoscopy-naive novices.
authors.affiliation: Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
authors.forename: Hendrikus J M
authors.initials: HJ
authors.lastname: Pullens
authors.affiliation: Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands.
authors.forename: Nanda
authors.initials: N
authors.lastname: van der Stap
authors.affiliation: Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands.
authors.forename: Esther D
authors.initials: ED
authors.lastname: Rozeboom
authors.affiliation: Department of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, the Netherlands.
authors.forename: Matthijs P
authors.initials: MP
authors.lastname: Schwartz
authors.affiliation: Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands.
authors.forename: Ferdi
authors.initials: F
authors.lastname: van der Heijden
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Martijn G H
authors.initials: MG
authors.lastname: van Oijen
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.affiliation: Department of Robotics and Mechatronics, University of Twente, Enschede, the Netherlands.
authors.forename: Ivo A M J
authors.initials: IA
authors.lastname: Broeders
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D003113:Colonoscopy / Q000379:methods*; D018592:Cross-Over Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D010865:Pilot Projects; D012371:Robotics