The measurement of forces exerted during colonoscopy

Background: The widely varying forces used at colonoscopy have not been measured. An electronic device was designed to measure the forces exerted by the clinician on the endoscope during colonoscopy. Methods: The device featured a handle designed in the shape of a hinged split cylinder that could be...

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Bibliographic Details
Published in:Gastrointestinal endoscopy 2000-08, Vol.52 (2), p.237-240
Main Authors: Appleyard, Mark N., Mosse, Charles A., Mills, Timothy N., Bell, G.Duncan, Castillo, Fortunato D., Swain, C.Paul
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Biomechanical Phenomena
Colonic Diseases - diagnosis
Colonoscopes
Colonoscopy - methods
Digestive system. Abdomen
Endoscopy
Equipment Design
Equipment Safety
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Pressure
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Summary:Background: The widely varying forces used at colonoscopy have not been measured. An electronic device was designed to measure the forces exerted by the clinician on the endoscope during colonoscopy. Methods: The device featured a handle designed in the shape of a hinged split cylinder that could be locked around the endoscope but readily moved up and down the insertion tube as the colonoscopy proceeded. This cylinder contained strain-gauges arranged so that the forces transmitted could be accurately measured. The device recorded the torque forces in addition to the push and pull forces exerted during diagnostic colonoscopy. Results: In a series of 21 colonoscopies in 20 patients: peak pushing force = 4.4 kg, pulling force = –1.8 kg, anti-clockwise torque = 1.0 Newton meters, clockwise torque = 0.8 Newton meters. Percentage time force greater than 1 kg = 5%. Peak anal insertion force = 1.8 kg. Conclusions: These measurements represent the first accurate measurements of the forces exerted during colonoscopy. Reducing the force during colonoscopy is likely to diminish pain and reduce the risk of perforation. A knowledge of these forces may also help with the design of new instruments and models for teaching or research.
ISSN:0016-5107
1097-6779
DOI:10.1067/mge.2000.107218