Cosentino Felice, Tumino Emanuele, Passoni Giovanni Rubis, Morandi Elisabetta, Capria Alfonso
Gastroenterology and Digestive Endoscopy, San Giuseppe Hospital, Milan, Italy.
Int J Artif Organs. 2009 Aug;32(8):517-27. doi: 10.1177/039139880903200806.
Currently, the best method for CRC screening is colonoscopy, which ideally (where possible) is performed under partial or deep sedation. This study aims to evaluate the efficacy of the Endotics System, a new robotic device composed of a workstation and a disposable probe, in performing accurate and well-tolerated colonoscopies. This new system could also be considered a precursor of other innovating vectors for atraumatic locomotion through natural orifices such as the bowel. The flexible probe adapts its shape to the complex contours of the colon, thereby exerting low strenuous forces during its movement. These novel characteristics allow for a painless and safe colonoscopy, thus eliminating all major associated risks such as infection, cardiopulmonary complications and colon perforation.
An experimental study was devised to investigate stress pattern differences between traditional and robotic colonoscopy, in which 40 enrolled patients underwent both robotic and standard colonoscopy within the same day.
The stress pattern related to robotic colonoscopy was 90% lower than that of standard colonoscopy. Additionally, the robotic colonoscopy demonstrated a higher diagnostic accuracy, since, due to the lower insufflation rate, it was able to visualize small polyps and angiodysplasias not seen during the standard colonoscopy. All patients rated the robotic colonoscopy as virtually painless compared to the standard colonoscopy, ranking pain and discomfort as 0.9 and 1.1 respectively, on a scale of O to 10, versus 6.9 and 6.8 respectively for the standard device.
The new Endotics System demonstrates efficacy in the diagnosis of colonic pathologies using a procedure nearly completely devoid of pain. Therefore, this system can also be looked upon as the first step toward developing and implementing colonoscopy with atraumatic locomotion through the bowel while maintaining a high level of diagnostic accuracy;
目前,结直肠癌筛查的最佳方法是结肠镜检查,理想情况下(如有可能)在部分或深度镇静下进行。本研究旨在评估Endotics系统(一种由工作站和一次性探头组成的新型机器人设备)在进行准确且耐受性良好的结肠镜检查方面的疗效。这个新系统也可被视为其他通过自然孔道(如肠道)进行无创移动的创新载体的先驱。柔性探头可根据结肠的复杂轮廓调整形状,从而在移动过程中施加较小的作用力。这些新颖的特性使得结肠镜检查无痛且安全,从而消除了所有主要的相关风险,如感染、心肺并发症和结肠穿孔。
设计了一项实验研究来调查传统结肠镜检查和机器人结肠镜检查之间的应激模式差异,40名入选患者在同一天接受了机器人结肠镜检查和标准结肠镜检查。
与机器人结肠镜检查相关的应激模式比标准结肠镜检查低90%。此外,机器人结肠镜检查显示出更高的诊断准确性,因为由于较低的充气率,它能够观察到标准结肠镜检查中未发现的小息肉和血管发育异常。与标准结肠镜检查相比,所有患者对机器人结肠镜检查的评价几乎无痛,疼痛和不适程度在0至10分的量表上分别为0.9和1.1,而标准设备分别为6.9和6.8。
新型Endotics系统在使用几乎完全无痛的程序诊断结肠病变方面显示出疗效。因此,该系统也可被视为朝着开发和实施通过肠道进行无创移动的结肠镜检查迈出的第一步,同时保持高水平的诊断准确性。