Evaluation of a Novel Colonoscope Designed for Easier Passage Through Flexures: A Randomized Study

Background and Study Aims: A new colonoscope (XCF-Q160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon.
Patients and Methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCF-Q160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’ grading of pain in a questionnaire.
Results: Cecal intubation rates were 85 % and 87 % for standard and prototype endoscopes, respectively (P = 0.57). On-demand sedation was given to nine (7 %) and 15 (11 %) of the patients, respectively (P = 0.17). Of the patients, 256 (85 %) returned their questionnaire, with 87 (63 %) in the standard group and 109 (77 %) in the prototype group reporting that they had experienced ‘no pain/slight pain’ (P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope.
Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.

References

• 1 Cotton P B, Connor P, McGee D. et al . Colonoscopy: practice variation among 69 hospital-based endoscopists.  Gastrointest Endosc. 2003;  58 639-640
• 2 Bowles C JA, Leicester R, Romaya C. et al . A prospective study of colonoscopy practice in the UK today: are we adequately prepared for national colorectal cancer screening tomorrow?.  Gut. 2004;  53 277-283
• 3 Ball J E, Osbourne J, Jowett S. et al . Quality improvement programme to achieve acceptable colonoscopy completion rates: prospective before and after study.  BMJ. 2004;  329 665-667
• 4 Dafnis G, Granath F, Påhlman L. et al . The impact of endoscopists’ experience and learning curves and interendoscopist variation on colonoscopy completion rates.  Endoscopy. 2001;  33 511-517
• 5 Bretthauer M, Hoff G, Severinsen H. et al . Systematic quality control programme for colonoscopy in an endoscopy centre in Norway [in Norwegian].  Tidsskr Nor Lægeforen. 2004;  124 1402-1405
• 6 Rex D K, Imperiale T F, Portish V. Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial.  Gastrointest Endosc. 1999;  49 554-559
• 7 Eckhardt V F, Kanzler G, Schmitt T. et al . Complications and adverse effects of colonoscopy with selective sedation.  Gastrointest Endosc. 1999;  49 560-565