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A Gentler Colonoscopy Without Sedation

NEW YORK (Jul 1, 2013)

Doctors at NewYork-Presbyterian are testing a computer-assisted colonoscope made of flexible material and guided by a physician using a joystick. The scope's flexibility and the physician's ability to delicately control movement may reduce the discomfort of traditional colonoscopy as well as the need for sedation – both considered reasons some forego this potentially lifesaving screening procedure.

The device, a robotic colonoscope manufactured by Invendo Medical, was developed in Germany and is already approved for use in Europe. It was recently approved by the U.S. Food and Drug Administration for use in the United States.

Benjamin Lebwohl, M.D.
Benjamin Lebwohl, M.D.

"Our study aims to determine whether polyp detection using this new device is similar to that of traditional colonoscopy," says Benjamin Lebwohl, M.D., a gastroenterologist at NewYork-Presbyterian. "Our hope is that this technology will allow for a more comfortable experience for the patient, and encourage screening among those who wish to have the procedure without sedation." Patients who would like to be considered for computer-assisted colonoscopy can email a request to newcolonoscopy@nyp.org.

Doctors are limiting the study to patients of average risk for colorectal cancer; age 50 or over; and in good health. They recommend patients at higher risk and/or in weaker health, such as those with heart disease or certain gastrointestinal conditions, undergo traditional colonoscopy until more experience is gathered with the new device.

In some ways, the new procedure is like traditional colonoscopy. Patients drink a solution the night before the procedure to purge waste from their colons. The scope is also introduced through the rectum and advanced to the top of the colon. Doctors examine the colon's interior while withdrawing the scope and can remove polyps if found.

Charles J. Lightdale, M.D.
Charles J. Lightdale, M.D.

As a safeguard with the new procedure, sedation can be introduced at any time if patients feel discomfort.

While millions of traditional colonoscopies are done annually in the United States, a significant number of eligible patients remain unscreened. The reasons are varied, and include lack of knowledge, fatalism about the disease, fear of preparation, limited access to medical care, anxiety regarding sedation, and lack of access to an escort (patients are not allowed to transport themselves unaccompanied from the hospital after the procedure with sedation).

"Far too many eligible Americans have not had potentially life-saving colon cancer screening with colonoscopy. In many cases, this is because colonoscopies are done using anesthesia, which requires an accompanying person to escort the patient home," says Charles J. Lightdale, M.D., also a gastroenterologist at NewYork-Presbyterian and a doctor helping conduct the study. "If the robotic colonoscope proves to be as effective as we believe, then this single-use device may become the preferred colonoscopy screening method for patients who want to avoid anesthesia."

If this new procedure removes the obstacles related to sedation, advocates are hopeful that it will be the right tool to encourage more people to be screened.

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