Colonoscopy with robotic steering and automated lumen centralization: a feasibility study in a colon model

Background and study aims: We introduced a new platform for performing colonoscopy with robotic steering and automated lumen centralization (RS-ALC) and evaluated its technical feasibility.\ud \ud Participants and 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.\ud \ud 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.\ud \ud Conclusions: Colonoscopy with RS-ALC is technically feasible and appears to be easier and more intuitive than conventional steering for endoscopy-naive novices