Feasibility study of a single-use balloon-assisted robotic colonoscope in healthy volunteers

Background and study aims Despite its widespread adoption, colonoscope still has its limitations. Advancement is often limited by the looping of colon. The isolation of SARS-CoV-2 in stool raises concern for the risk of disease transmission. A single-use robotic colonoscope, the NISInspire-C System, that features a balloon-suction anchorage mechanism was developed to address these. Methods The NISInspire-C balloons are designed to provide anchorage for straightening of the colon during advancement. Angulation at the bending section is tendon-wire driven by servo mechanisms integrated into a robotic control console. This was a pilot, prospective trial to evaluate the safety and feasibility of this system. Healthy volunteers underwent examination with the NISInspire-C, followed by the conventional colonoscope. The procedure time, cecal intubation rates (CIR), complications, and level of pain were measured. Results A total of 19 subjects underwent the examination. The cecal intubation rate was 89.5 % (17/19) and the overall time-to-cecum was 26.3 minutes (SD: 17.9 mins). There were no procedure-related complications. Polyps were detected in seven of 19 (36.8 %) subjects during the NISInspire-C procedure. Three more subjects were found to have adenomatous polyps with the conventional colonoscope. There was minimal variation in level of pain during the procedures with the two colonoscopes. Conclusion The single-use robotic colonoscope NISInspire-C is a safe and feasible alternative to the conventional colonoscope. Further technical refinement is needed to improve the CIR. This study was limited by its small sample size.

A simple and reliable reel mechanism-based robotic colonoscope for high mobility

Colonoscopes are one The first two authors contributed equally to this work of the best tools to detect colorectal cancer despite their several drawbacks. In order to solve the limitations of conventional colonoscopes and detect cancer more efficiently, robotic colonoscopes and capsule endoscopes have been proposed. However, active capsule endoscopes require expensive control systems, and they have functional limitations due to their small volumes. In addition, robotic colonoscopes fail to achieve sufficient mobility, resulting in longer colonoscopy times than with conventional colonoscopes. Therefore, the present study proposes a simple, reliable reel mechanism-based robotic colonoscope that achieves high mobility. Because the robot is operated by a reel with an external high-capacity motor, enhanced mobility is attained regardless of environment. Moreover, the proposed robotic colonoscope allows for the inclusion of an instrument channel, unlike previously reported robotic colonoscopes. A theoretical analysis is implemented to confirm the mobile performance. The analysis results are compared with the results of a locomotion test in a urethane tube (diameter = 28 mm). Ultimately, the robot achieves high mobility (66.04 ± 5.97 mm/s with a motor speed of 200 r/min), and the error between the theoretical and experimental results is less than 1%. Furthermore, an in-vitro test in an excised porcine colon is performed to verify the feasibility of the locomotion in a large intestine. In straight and sloping paths (30° and 45°), the robot travels at 21.11 ± 1.69 mm/s, 18.77 ± 3.42 mm/s, and 8.76 ± 1.68 mm/s, respectively, with a motor speed of 150 r/min. This is within the reliable operation range for colonoscopies.