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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(02): E171-E180
DOI: 10.1055/a-1314-9860
Original article

Magnetic flexible endoscope for colonoscopy: an initial learning curve analysis

Alexander P. Mamunes
1   Division of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Federico Campisano
2   Mechanical Engineering Department, Vanderbilt University, Nashville, Tennessee, United States
,
James Martin
3   STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
,
Bruno Scaglioni
3   STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
,
Evangelos Mazomenos
3   STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
,
Pietro Valdastri
3   STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
,
Keith L. Obstein
4   Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
2   Mechanical Engineering Department, Vanderbilt University, Nashville, Tennessee, United States
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Abstract

Background and study aims Colonoscopy is a technically challenging procedure that requires extensive training to minimize discomfort and avoid trauma due to its drive mechanism. Our academic team developed a magnetic flexible endoscope (MFE) actuated by magnetic coupling under supervisory robotic control to enable a front-pull maneuvering mechanism, with a motion controller user interface, to minimize colon wall stress and potentially reduce the learning curve. We aimed to evaluate this learning curve and understand the user experience.

Methods Five novices (no endoscopy experience), five experienced endoscopists, and five experienced MFE users each performed 40 trials on a model colon using 1:1 block randomization between a pediatric colonoscope (PCF) and the MFE. Cecal intubation (CI) success, time to cecum, and user experience (NASA task load index) were measured. Learning curves were determined by the number of trials needed to reach minimum and average proficiency—defined as the slowest average CI time by an experienced user and the average CI time by all experienced users, respectively.

Results MFE minimum proficiency was achieved by all five novices (median 3.92 trials) and five experienced endoscopists (median 2.65 trials). MFE average proficiency was achieved by four novices (median 14.21 trials) and four experienced endoscopists (median 7.00 trials). PCF minimum and average proficiency levels were achieved by only one novice. Novices’ perceived workload with the MFE significantly improved after obtaining minimum proficiency.

Conclusions The MFE has a short learning curve for users with no prior experience—requiring relatively few attempts to reach proficiency and at a reduced perceived workload.



Publication History

Received: 06 June 2020

Accepted: 13 October 2020

Article published online:
25 January 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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