New Approach to Colonoscopy Tested

Colonoscopy is an effective screening tool for colorectal cancer, but must be conducted by a highly trained individual.

In order to make colonoscopy more widely available, researchers have tested an approach that uses a self-propelling, self-navigating device.

Colorectal cancer is the second leading cause of cancer-related deaths in the U.S. The disease develops in the large intestine, which includes the colon (the longest part of the large intestine) and the rectum (the last several inches).

Screening tests for colorectal cancer include checking the stool for blood, sigmoidoscopy, colonoscopy, barium enema, and digital rectal exam. During a colonoscopy, a lighted instrument called a colonoscope is used to view the rectum and the entire colon. Pictures and samples of tissue (biopsies) may be taken for further evaluation by the physician.

The conventional approach to colonoscopy requires a highly-trained operator. Developing an approach that could be more widely used could increase the availability and decrease the cost of colonoscopy. One alternative approach being evaluated is a colonoscope that advances itself through the colon. Called the Aer-O-Scope™, it uses a balloon to carry a scope through the colon. Changes in air pressure move the balloon forward or back, and the pressure on the walls of the colon is constantly monitored.

To assess how the Aer-O-Scope performs in humans, researchers from Croatia, the U.S., and Israel conducted a study among twelve healthy volunteers. The study participants were between the ages of 20 and 43.

Study subjects underwent bowel preparation one day before the procedure. Participants were not sedated during use of the Aer-O-Scope, though they could request pain medication during the procedure. After use of the Aer-O-Scope, patients underwent conventional colonoscopy.

  • In 10 of the 12 subjects, the Aer-O-Scope was able to travel through the entire colon. In the remaining two subjects, neither the Aer-O-Scope nor conventional colonoscopy were able to evaluate the entire colon. Inability to view the entire colon was due to pain in one subject and a condition known as redundant colon in the other subject.
  • Two subjects requested pain medication during use of the Aer-O-Scope.
  • Four subjects experienced sweating and a bloating sensation that resolved on its own.

The researchers conclude that the Aer-O-Scope effectively evaluated all or most of the colon. They note that larger studies will be needed to confirm the safety of the procedure and to evaluate its use in older individuals.

Reference: Vucelic B, Rex D, Pulanic R et al. The Aer-O-Scope: Proof of Concept of A Pneumatic, Skill-Independent, Self-Propelling, Self-Navigating Colonoscope. Gastroenterology. 2006;130:672-677.

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