Appleyard M N, Mosse C A, Mills T N, Bell G D, Castillo F D, Swain C P
Department of Medical Physics, University College London, Royal London Hospital, London, UK.
Gastrointest Endosc. 2000 Aug;52(2):237-40. doi: 10.1067/mge.2000.107218.
The widely varying forces used at colonoscopy have not been measured. An electronic device was designed to measure the forces exerted by the clinician on the endoscope during colonoscopy.
The device featured a handle designed in the shape of a hinged split cylinder that could be locked around the endoscope but readily moved up and down the insertion tube as the colonoscopy proceeded. This cylinder contained strain-gauges arranged so that the forces transmitted could be accurately measured. The device recorded the torque forces in addition to the push and pull forces exerted during diagnostic colonoscopy.
In a series of 21 colonoscopies in 20 patients: peak pushing force = 4.4 kg, pulling force = -1.8 kg, anti-clockwise torque = 1.0 Newton meters, clockwise torque = 0.8 Newton meters. Percentage time force greater than 1 kg = 5%. Peak anal insertion force = 1.8 kg.
These measurements represent the first accurate measurements of the forces exerted during colonoscopy. Reducing the force during colonoscopy is likely to diminish pain and reduce the risk of perforation. A knowledge of these forces may also help with the design of new instruments and models for teaching or research.
结肠镜检查时所使用的力量差异很大，此前尚未进行过测量。设计了一种电子设备来测量结肠镜检查过程中临床医生施加在内窥镜上的力量。
该设备的手柄设计为铰接式开口圆柱体形状，可锁定在内窥镜周围，但在结肠镜检查过程中可轻松沿插入管上下移动。该圆柱体内装有应变片，其布置方式能够精确测量传递的力。该设备除了记录诊断性结肠镜检查过程中施加的推拉力外，还记录扭矩力。
在对20名患者进行的21次结肠镜检查系列中：最大推拉力 = 4.4千克，拉力 = -1.8千克，逆时针扭矩 = 1.0牛顿米，顺时针扭矩 = 0.8牛顿米。力量大于1千克的时间百分比 = 5%。最大肛门插入力 = 1.8千克。
这些测量结果代表了结肠镜检查过程中所施加力量的首次精确测量。在结肠镜检查过程中降低力量可能会减轻疼痛并降低穿孔风险。了解这些力量也可能有助于新型教学或研究仪器及模型的设计。
