Robotic Colonoscopy

A Robotic Colonoscopy is a medical examination which is painless, safer, uses disposable materials, and is alternative to and in some case in addition to a traditional colonoscopy. This is a painless exam, as it uses an extremely flexible instrument which moves using “rear traction”, that is to say without external pressure. For this reason the probe travels along the curves of the colon rendering it non traumatic and painless.

Robotic and traditional Colonoscopy

What are the differences?

Traditional colonoscopy uses an endoscopic probe which is manually pushed along the colon by a specialized doctor. For this reason a traditional colonoscopy is an invasive painful exam which requires appropriate sedation.

Robotic Colonoscopy is a computerized system which uses a very flexible silicon cylinder (the actual colonoscope) which thanks to a hydraulic mechanism can be lengthened or shortened. At the top and bottom of the cylinder (elongator) there are two anchoring systems (clamper) permitting the system to attach itself to the mucus by carefully suctioning itself to it. This allows the colonoscope to move forward (in much the same way as a caterpillar) along the colon on its own, following bends without any mechanical action or external force. That is why there is minimum or no discomfort for the patient whatsoever.

The system’s endoscopic probe used to carry out the Robotic Colonoscopy has a diameter of 17 mm and is 25 cm long, it is connected to a mechanical base by a smaller probe with a diameter of only 7.5 mm but containing control mechanisms and the operative canal for the passage of attachments (biopsy pincers, a loop for the removal of polyps, etc.) Therefore a robotic colonoscopy, compared to a traditional colonoscopy, permits the doctor to perform operative procedures such as biopsies or the removal of polyps.

Robotic Colonoscopy video presentation

What are the advantages? 

The advantages with respect to the traditional technique are numerous:

• No pain;
• No need for sedative drugs, meaning that the recovery period is faster and immediate;
• Safer, in that it uses a disposable instrument. In addition the robotic system reduces almost completely the risk of perforation;

During the endoscopic exploration, with duration of a minimum of 20 minutes to a maximum of 60, the patient can speak with the doctor and refer their needs or ask how the exam is proceeding. Decreased emotional tension makes the robotic colonoscopy a much easier exam to undergo for the patient.

How is it performed?

Procedure

A Robotic Colonoscopy can be performed after a proper preparation, identical to the preparation required for a traditional colonoscopy, unless a colon wash is performed. Preparation for a robotic colonoscopy must be more scrupulous as any residual faecal matter may not only interfere with visual images, it may also compromise the anchoring and advancement of the instrument.

During the course of the examination the patient is generally asked to lie on their left side. During the exam, in order to ease the progression of the device, the patient may be asked to change position (lay on their back, on their right side). Also abdominal compressions may be required in order to feel for the probe and help in areas where it may encounter difficulty along its path.

A robotic colonoscopy is usually well tolerated by the patients in that the advancement of the device is completely non traumatic. However, the injection of air necessary to stretch the colon could, in cases of a low pain threshold, determine the sensation of pain/discomfort.

Can polyps be removed or biopsies done with a robotic colonoscopy?  

Yes. The 3 mm operating canal makes it possible to perform biopsies. Using the pincer or diathermic loop, the removal of polyps under one centimetre is possible. For polyps larger than 10-15 mm it is theoretically possible to remove them however it cannot be guaranteed for various reasons: shape of the polyp (sessile or peduncular), position in the colon, etc… For larger polyps a conventional colonoscopy is recommended

A Robotic colonoscopy is a technique that is routinely used in various structures of national relevance in Italy, Switzerland, and the United Kingdom. This technique is therefore only available in certain specialized centres which have the skills and instruments necessary to perform this painless technique.

What are the limitations of a robotic colonoscopy?

Just like any new method, robotic colonoscopy has its limits. The diameter of the robotic colonoscope is 4 mm larger than conventional colonoscope, making it more difficult if not impossible to perform the examination in patients with narrowing of the anus due to scarring or with narrow sections of the colon (sub stenosis due to diverticulitis, due to inflammatory disease, or tumours, etc.), above all because of the weak nature of the propulsion of the device, that on the other hand is why it is so safe. In addition, at the moment, it has not yet been tested in complex operative endoscopic procedures (dilatation, positioning, endoprosthesis, complex polypectomy, etc.).

Opinions and Robotic Colonoscopy

In some of our CertisMed centres it is possible to book a Robotic Colonoscopy. After each individual procedure the patient who underwent the procedure is asked their opinion, of particular interest are the opinions of patients who have previously undergone at least one traditional gastroscopy.

What is the opinion of doctors about robotic colonoscopy?

The opinion of doctors that carry out the robotic colonoscopy is mostly very positive. Actually since the robotic colonoscopy is performed without sedation, it is possible therefore to have the patient actively cooperate with the doctor during the examination, meaning that the specialist can perform the procedure in a more relaxed and often more efficient manner.

What is the patient’s opinion of the robotic colonoscopy?

Just like the doctors, the patients also provide very positive opinions after having had a robotic colonoscopy. The examination is actually much better tolerated than a traditional colonoscopy, especially because they can avoid taking sedatives which often times frighten patients. The possibility of visually following the examination makes the patient calmer and more cooperative.

Where to have the exam done?

What are the centres that perform Robotic Colonoscopy?

In some CertisMed centres it’s possible to request a booking for this exam. Anyone interested can contact the patient answering service to request more information about the centres where robotic colonoscopy is done.