Robotic colonoscopy: efficacy, tolerability and safety. Preliminary clinical results from a pilot study

BACKGROUND: Robotic colonoscopy (RC) is a pneumatically-driven self-propelling platform (Endotics System®) able to investigate the colon, in order to reduce pain and discomfort. AIMS: (1) to describe the progress in gaining experience and skills of a trainee in RC; (2) to show the clinical outcomes of RC. METHODS: Pilot study. An experienced endoscopist started a training on RC whose progress was assessed comparing the results of 2 consecutive blocks of 27 (Group A) and 28 (Group B) procedures. CIR (Cecal Intubation Rate), CIT (Cecal Intubation Time) and Withdrawal Time (WT) were measured. Polyp Detection Rate (PDR), Adenoma Detection Rate (ADR) and Advanced Neoplasia Detection Rate (ANDR) were calculated. Possible adverse events were recorded. At the end of the procedure all patients completed a visual analog scale (VAS) to measure their perceived pain during RC and reported their willingness to repeat RC. RESULTS: General CIR was 92.7%, reaching 100% in Group B. Comparing the two groups, CIT significantly decreased from 55 to 22 min (p value 0.0007), whereas procedures with CIT ≤ 20 min increased (p value 0.037). WT significatively reduced from 21 to 16 min (p value 0.0186). PDR was 40% (males 62.5%, females 14.3%). ADR was 26.7% (males 27.5%, females 14.3%). Most of patients judged the procedure as mild or no distress, with high willingness-to-repeat the RC (92.7%). CONCLUSIONS: Our results about RC are encouraging as preliminary experience, with clear individual learning progress, accurate diagnosis in a painless or comfortable procedure and with possibility to remove polypoid lesions. Studies with larger populations are needed to confirm obtained results.