title: A novel self-propelled disposable colonoscope is effective for colonoscopy in humans (with video).
abstract: OBJECTIVE
  The self-propelled disposable colonoscope (SPDC) with a 360° view is designed to enhance visualization, minimize risks of perforation and infection transmission, and shorten operator training time associated with conventional colonoscopy (CC). We evaluated SPDC efficacy for cecal intubation and safety.
  
  
  METHODS
  Prospective patients presenting for colorectal cancer screening underwent SPDC immediately followed by CC. Initial patients necessary for SPDC operators to achieve proficiency comprised the training cohort. Subsequent enrolled patients comprised the study cohort. SPDC colonoscopy was performed up to the cecum, where anatomic landmarks were photographed and mucosal suction marks were placed. During SPDC withdrawal, polyps were recorded and similarly marked. On the second pass (by using CC), any potential mucosal damage and suction marks from the SPDC as well as polyps were recorded. Main endpoints included SPDC cecal intubation rates, confirmed by anatomic landmarks and residual marks seen on subsequent CC, and frequency and severity of adverse events and mucosal damage with SPDC. The secondary endpoint was subjective procedure proficiency, evaluated by the operator based on the training cohort. The tertiary endpoint was documenting pathologies visualized with SPDC.
  
  
  RESULTS
  Fifty-six of 58 enrolled subjects completed the study. Proficiency with SPDC was attained after 8 to 10 procedures. Cecal intubation was successful in 98.2% (55/56 subjects; 95% confidence interval [CI], 90.4%-99.9%), including 100% (95% CI, 90.7%-100%) of the study cohort and 94.4% (95% CI, 72.7%-99.9%) of the training cohort. No mucosal damage or adverse events were reported. SPDC detected 87.5% of polyps seen in tandem CC, including all polyps larger than 5 mm.
  
  
  CONCLUSIONS
  SPDC was highly successful, simple to use, and safe in achieving complete colonoscopy (cecal intubation). (
  
  
  BACKGROUND
  0692-12-TLV.).
authors.affiliation: Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Nathan
authors.initials: N
authors.lastname: Gluck
authors.affiliation: Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alaa
authors.initials: A
authors.lastname: Melhem
authors.affiliation: Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.affiliation: Digestive Health Services, Tacoma, Washington, USA.
authors.forename: Klaus
authors.initials: K
authors.lastname: Mergener
authors.affiliation: Tel Aviv Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Erwin
authors.initials: E
authors.lastname: Santo
mesh_terms: D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D002432:Cecum; D002983:Clinical Competence; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D020685:Colonoscopes / Q000009:adverse effects; D003113:Colonoscopy / Q000009:adverse effects / Q000295:instrumentation*; D004209:Disposable Equipment; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000293:injuries; D007441:Intubation, Gastrointestinal; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies