Magnetic endoscope imaging for routine colonoscopy: impact on propofol dosage and patient safety – a randomized trial

Klare, Peter; Hartrampf, Bonnie; Haller, Bernhard; Schlag, Christoph; Geisler, Fabian; Abdelhafez, Mohamed; Einwächter, Henrik; Bajbouj, Monther; Schmid, Roland M.; Delius, Stefan von

doi:10.1055/s-0042-110933

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…It involved patients who were given “conscious sedation” using midazolam and fentanyl as compared to a growing trend of performing these procedures under deep sedation using propofol administered by anesthesia professionals 13 . Despite moderate sedation, the outcomes were within the scope of a traditional practice with fewer side effects and reasonable patient satisfaction scores achieving good standard-of-care quality measures, which is in comparison to another study that showed lower doses of propofol in the MEI group 14 . Use of deep sedation can limit position changes.…”

Section: Discussionmentioning

confidence: 59%

Outcomes of use of electromagnetic guidance with responsive insertion technology (RIT) during colonoscopy: a prospective randomized controlled trial

et al. 2019

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Background and study aims Colonoscopy can be technically challenging and cause discomfort in patients. The integrated Scope Guide assist is built in to show that with its use outcomes are improved during colonoscopy. We aimed to test the usefulness of the Magnetic Scope Guide Assist (ScopeGuide ) with respect to cecal intubation time, and other procedural quality outcomes. Patients and methods We conducted a prospective study of outpatients undergoing elective colonoscopy at the endoscopic units of the University of Alabama at Birmingham (UAB) from March 2016 to July 2016. Patients were randomly assigned in a 1:1 block design to groups that either had standard colonoscopy or Scope-guided colonoscopy. The primary outcome measure was cecal intubation time (CIT). Secondary outcome measures included use of manual pressure, position changes for cecal intubation and sedation requirements. Results Three hundred patients were randomized to either group; standard (n = 150) vs. Scope-guided (n = 150). The mean CIT was not statistically different for the standard and the Scope-guided groups (4.6 vs. 4.3 minutes; P = 0.46). There were also no statistical differences in frequency of manual pressure applied (16.7 % for Scope-guided vs. 19.1 % for standard; P = 0.65) or position changes (11.4 % for scope guided vs. 8.8 % standard; P = 0.56). Sedation requirements showed lesser use of midazolam (3.9 mg vs. 4.7 mg, P = 0.003) in the Scope-guide group, while there was no significant difference in use of fentanyl (fentanyl – 62.1 mg vs. 68.9 mg, P = 0.09 similar between groups, for Scope-guided vs. standard groups, respectively). Adverse events were similar in both groups. Conclusions In patients undergoing routine elective colonoscopy, use of ScopeGuide by experienced colonoscopists did not improve CIT or affect the frequency of ancillary maneuvers. The benefit of this device during training of endoscopists could be considered for further studies.

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Section: Discussionmentioning

confidence: 59%

Outcomes of use of electromagnetic guidance with responsive insertion technology (RIT) during colonoscopy: a prospective randomized controlled trial

et al. 2019

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“…Data on magnetic imagers have been available for over 20 years, but only recently did the largest meta-analysis to date come down in favour of their use for reducing time to caecum (even in expert hands), increasing caecal intubation rate and reducing pain scores 10 . A more recent unblinded study 11 of propofol usage in a colonoscopy population was able to demonstrate increased satisfaction scores and reduced propofol use with a magnetic imager, and as a further study has demonstrated that propofol-supported colonoscopy is associated with higher complication rates 12 , it is interesting to hypothesise that a suitably powered study could demonstrate improved safety as well. The most exciting contribution to improvements in colonoscopic insertion technique has been the advent of water-assisted insertion techniques.…”

Section: Colonoscopy Insertionmentioning

confidence: 98%

Recent advances in colonoscopy

Seward

2019

F1000Res

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Colonoscopy continues to evolve as equipment and techniques improve. Traditionally, colonoscopy has focused on adenoma detection, characterisation and resection as the primary aims, and there has certainly been considerable activity over the last few years in terms of addressing these important issues. This review article not only will discuss progress made in these areas but also will focus on when to colonoscope in terms of introduction of faecal immunochemical testing, how to insert with the advent of water-assisted insertion, and how to withdraw using a bundle of evidence-based techniques to improve adenoma detection. In addition, the ramifications of failing to discover polyps and of post-colonoscopy colorectal cancer are highlighted.

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“…P aediatric ileo-colonoscopy (IC) can be technically challenging because of unpredictable colonoscope loop formation mainly in the sigmoid and transverse colon. The magnetic endoscope imaging (MEI) tool (ScopeGuide, Olympus, America, Inc, Allentown, PA) (1,2) is a non-radiographical technique for picturing the colonoscope shaft in real time (3)(4)(5) and it represents a useful tool for training purposes (6). Studies on loop formation have been published in adults (7)(8)(9) but no studies so far have been conducted in paediatric IC.…”

mentioning

confidence: 99%

Colonoscope “Looping” During Ileo‐Colonoscopy in Children is Significantly Different to that Observed in Adult Practice

Thomson¹,

Belsha²,

Nedelkopoulou³

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives:Ileo-colonoscopy (IC) can be technically challenging because of unpredictable colonoscope loop formation. Aims of this study were to assess the risk of loop formation and to attempt to understand which factors were likely to predispose to which subtype of loop.Methods:Prospective study conducted on children referred for an IC at Sheffield Children's Hospital. Presence and type of loop was objectively assessed using the magnetic endoscope imaging tool.Results:Three hundred procedures were prospectively evaluated. Only 9% of paediatric ICs were loop-free. Alpha loops were the most common loop in children older than 5, whereas reverse alpha loops and a wider variety of complex and repetitive loops were observed in younger patients. Once a specific type of loop has formed, the risk of re-looping in a different way or in a different position of the colon is reduced. Left lateral starting position was found to increase the risk of reverse alpha loops and re-looping. Challenging loops, such as reverse alpha, were more frequent in males. Higher body mass index (BMI) was associated with an increased risk of alpha and deep transverse loops formation, while lower BMI with a higher incidence of reverse alpha and N loop. Loop formation did not prevent 100% ileal intubation.Conclusions:This study represents the first attempt to describe loop formation according to patient characteristics in a large paediatric series. Further studies are needed in order to establish if these findings could be helpful in simplifying the execution of IC procedures in children and facilitate the learning curve during endoscopy training programs.

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Magnetic endoscope imaging for routine colonoscopy: impact on propofol dosage and patient safety – a randomized trial

Abstract: The use of MEI may be useful in reducing propofol dosage for colonoscopy and improving patient satisfaction.ClinicalTrials.gov identifier: NCT02121704.

Cited by 7 publications

References 26 publications

Outcomes of use of electromagnetic guidance with responsive insertion technology (RIT) during colonoscopy: a prospective randomized controlled trial

Outcomes of use of electromagnetic guidance with responsive insertion technology (RIT) during colonoscopy: a prospective randomized controlled trial

Recent advances in colonoscopy

Colonoscope “Looping” During Ileo‐Colonoscopy in Children is Significantly Different to that Observed in Adult Practice

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