ABSTRACT
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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;
Subject(s)
Colon/pathology , Colonic Diseases/diagnosis , Colonoscopes , Colonoscopy/instrumentation , Disposable Equipment , Robotics/instrumentation , Surgery, Computer-Assisted/instrumentation , Adult , Colonic Diseases/pathology , Colonoscopes/adverse effects , Colonoscopy/adverse effects , Female , Humans , Italy , Male , Materials Testing , Middle Aged , Models, Anatomic , Pain/etiology , Pain Measurement , Patient Satisfaction , Predictive Value of Tests , Prospective Studies , Surgery, Computer-Assisted/adverse effects , Surveys and QuestionnairesABSTRACT
BACKGROUND: Gastric bezoars may develop in the proximal pouch after gastric restriction. METHODS: Of 299 patients who underwent laparoscopic adjustable gastric banding (LAGB), 4 developed gastric bezoars at different intervals after surgery (24 days, 8 months, 18 months, and 6 years). RESULTS: Symptoms of high dysphagia and vomiting occurred in all 4 patients. Removal of the bezoars via endoscopy was uneventful, and all patients have maintained their gastric band. Patients were emphasized to avoid rapid intake of high-residue cellulose foods, and to achieve complete mastication. No bezoar has recurred in these patients at 7 to 75 months further follow-up. CONCLUSION: Gastric bezoar should be considered after LAGB if the patient complains of persistent high fullness and vomiting.
