A new, painless device could revolutionise colonoscopies – with no need for the patient to be sedated and little or no discomfort caused. Its developers say more people may opt to have colon cancer screening tests, so diseases such as bowel cancer would be picked up much earlier.
The device, driven in and out of the colon using tiny wheels, is navigated with the help of a joystick – similar to those used in computer games.
“Conventional colonoscopes are semi-rigid and have a large, bending tube, which is difficult to push around a curve,” says Michael Rosenbruch, of German makers Invendo Medical.
“This can result in significant pressure on the colon walls, which can be painful and uncomfortable. Our system is driven through the colon, following the anatomy, with minimal pressure on the colon walls.”
Millions of colonoscopies a year are carried out across the world. They can be used to screen for such conditions as bowel cancer and Crohn’s disease, and to help find the cause of symptoms such as changes in bowel habits or abdominal pain.
Colonoscopy is nearly always done when the patient is sedated or anaesthetised. There is a very small risk – in fewer than one in 500 tests – of the bowel perforating during the procedure and needing surgical repair.
The new device, which is expected to be launched next year, consists of an inner endoscope sheath – a long flexible instrument which can be passed into the body to view various structures – with an outer sleeve.
It can move forward or backwards at the touch of a remote control button that activates its tiny wheels. The wheels grab on to the inner side of the sleeve and drive it forward, pulling the inner endoscope sheath along. The tip can be navigated by the doctor using a joystick to steer it through the colon.
At the end of this device, known as an invendoscope, is a mini-camera that sends images of the inside of the colon to a monitor screen, which the doctor uses for navigation. The wheels mean there is no direct pressure against the bowel tissue. The patient, therefore, experiences minimal discomfort, even without sedation. It is used only once and then thrown away.
Results from a trial show that the device is highly effective. More than 90 per cent of the volunteers felt no, or only minimal, discomfort during a colonoscopy, despite not being sedated.
“These results are exciting because this new technology might significantly increase the numbers of patients who have colonoscopies who were previously afraid to do so because of the potential pain and because they have to be sedated,” says Professor Thomas Rösch, head of endoscopy at Germany-based Charité University Hospital, who led the trial.
While colon cancer is the third most common cancer after breast and lung, with more than 35,000 new cases a year, it can be tackled successfully if diagnosed early.
“The prospect of a pain-free colonoscopy holds great potential,” said Professor Wendy Atkin, of Cancer Research UK’s colorectal unit. “Detecting bowel cancer early is vital and screening will save many lives each year.”
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