Objective Differences in Colonoscopy Technique Between Trainee and Expert Endoscopists Using the Colonoscopy Force Monitor

Background Learning to perform colonoscopy safely and effectively is central to gastroenterology fellowship programs. The application of force to the colonoscope is an important part of colonoscopy technique. Aims We compared force application during colonoscopy between novice and expert endoscopist...

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Bibliographic Details
Published in:Digestive diseases and sciences 2018, Vol.63 (1), p.46-52
Main Authors: Ende, Alexander R., De Groen, Piet, Balmadrid, Bryan L., Hwang, Joo Ha, Inadomi, John, Wojtera, Tomasz, Egorov, Vladimir, Sarvazyan, Noune, Korman, Louis
Format: Article
Language:English
Subjects:
Adult
Aged
Biochemistry
Clinical Competence
Cohort Studies
Colonoscopes
Colonoscopy
Colonoscopy - methods
Comparative analysis
Continuing medical education
Education, Medical, Continuing
Education, Medical, Graduate
Equipment Design
Equipment Safety
Female
Gastroenterology
Gastroenterology - education
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Methods
Middle Aged
Monitoring, Physiologic
Oncology
Original Article
Pressure
Stress, Mechanical
Transplant Surgery
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Summary:Background Learning to perform colonoscopy safely and effectively is central to gastroenterology fellowship programs. The application of force to the colonoscope is an important part of colonoscopy technique. Aims We compared force application during colonoscopy between novice and expert endoscopists using a novel device to determine differences in colonoscopy technique. Methods This is an observational cohort study designed to compare force application during colonoscopy between novice and experienced trainees, made up of gastroenterology fellows from two training programs, and expert endoscopists from both academic and private practice settings. Results Force recordings were obtained for 257 colonoscopies by 37 endoscopists, 21 of whom were trainees. Experts used higher average forward forces during insertion compared to all trainees and significantly less clockwise torque compared to novice trainees. Conclusions We present significant, objective differences in colonoscopy technique between novice trainees, experienced trainees, and expert endoscopists. These findings suggest that the colonoscopy force monitor is an objective tool for measuring proficiency in colonoscopy. Furthermore, the device may be used as a teaching tool in training and continued medical education programs.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-017-4847-9