ScopeGuide-assisted Colonoscopy Versus Conventional Colonoscopy

Colonoscopy is an established technology that enables doctors to obtain live video from inside patients' large intestines, which is essential for the diagnosis of numerous intestinal illnesses. It consists of a long, flexible tube fitted with a light-source and small video camera that transmits the images onto a display monitor. The doctor inserts the scope into the anus, moves it into the rectum and then guides it slowly through the entire colon. Because of the various twists and turns that are part of normal bowel anatomy, advancing the scope through the entire colon is not always successful and can become challenging when the scope forms loops inside the abdomen. Unfortunately, there is no way for the doctor to see the shape of the scope inside the body other than what is seen from the video at its front end, and so navigating the colon relies on instinct accumulated with experience and the "feel" of the scope as loops begin to form. This is important because not only can this loop formation cause pain, but it can also increase the likelihood of an incomplete test. Incomplete tests matter because a major reason for performing colonoscopy is colon cancer screening and surveillance; detecting early cancers at treatable stages and looking for polyps that may be pre-cancerous growths. When colonoscopy does not advance through the entire colon, parts are left unexamined where cancer may develop. A new technology called "ScopeGuide" has been developed that uses magnetic coils embedded within the scope to create a 3D image of the shape of the entire scope inside the body that is projected onto the monitor for the doctor to see. This will show if loops are forming and will provide information about how to eliminate loops once they have formed. In this research study, the investigators will compare colonoscopy with the assistance of ScopeGuide to colonoscopy performed in the standard fashion, to see if ScopeGuide results in more successful procedures that are easier for the doctor and more comfortable for patients.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

1. Adult patient 18 years or older.
2. Able to read \& write English.
3. Undergoing colonoscopy at University of Alberta Hospital for any indication.

Exclusion Criteria:

1. Colonoscopy performed without prior purgative bowel prep.
2. Patient with active, ongoing lower GI bleeding.
3. Colonoscopy performed to attempt colonic decompression in acute colonic pseudo-obstruction (Ogilvie's syndrome).
4. Colonoscopy for which propofol sedation is required.
5. Inpatient colonoscopy performed by a trainee under staff supervision.
6. Patient with previous colonic surgery.
7. Patient with pacemaker or implantable cardioverter-defibrillator (ICD).

• BACKGROUNDShah SG, Brooker JC, Williams CB, Thapar C, Saunders BP. Effect of magnetic endoscope imaging on colonoscopy performance: a randomised controlled trial. Lancet. 2000 Nov 18;356(9243):1718-22. doi: 10.1016/S0140-6736(00)03205-0. PMID 11095259
• BACKGROUNDShah SG, Brooker JC, Thapar C, Suzuki N, Williams CB, Saunders BP. Effect of magnetic endoscope imaging on patient tolerance and sedation requirements during colonoscopy: a randomized controlled trial. Gastrointest Endosc. 2002 Jun;55(7):832-7. doi: 10.1067/mge.2002.124097. PMID 12024136
• DERIVEDTeshima CW, Zepeda-Gomez S, AlShankiti SH, Sandha GS. Magnetic imaging-assisted colonoscopy vs conventional colonoscopy: a randomized controlled trial. World J Gastroenterol. 2014 Sep 28;20(36):13178-84. doi: 10.3748/wjg.v20.i36.13178. PMID 25278714