Detection of Looping During Colonoscopy Using Bending Sensors

During colonoscopy, looping of the colonoscope shaft is considered one of the biggest challenges of the procedure. It hinders the advancement of the distal tip of the colonoscope requiring time to retract and straighten the shaft. Consequently, anesthesia exposure and operative time, and associated risk and cost are all increased. Many active and passive auxiliary devices have been introduced to overcome looping problems but only select devices were utilized due to safety, complexity, or cost issues. In this study, a low cost looping detection system embedded in the shaft of the colonoscope and the corresponding software algorithm have been evaluated. Thirty bending sensors were inserted inside the shaft of the colonoscope, which sent voltage signals to the analog-digital converter. Digital signals were transmitted to the computer for software analysis of the looping status of the colonoscope shaft. A colonoscopist can often detect the beginning of the looping process and can initiate maneuvers to correct and avoid the looping, which frequently are successful. A standard colonoscopy training model was utilized to test the looping detection system, which effectively demonstrated loop formation, providing data to the endoscopist that is helpful for initiation of appropriate loop avoidance techniques. Maintenance of the bending sensors and a learning curve of the system can be potential limitations.