A Colonoscopy Training Environment with Real-Time Pressure Monitoring.

Colonoscopy is the most commonly used procedure for screening and diagnosing colorectal cancers. The number of colonoscopy procedures performed each year is increasing as colon cancer currently ranks second among the leading cancers causing death worldwide. One of the significant factors resulting in incomplete colonoscopy procedures is pain and discomfort caused by the use of excessive force by the endoscopist. Learning the necessary skills for performing a successful procedure is technically challenging and requires substantial training. The present learning techniques primarily focus on completing the procedure rather than on controlling the applied pressure transmitted by the colonoscope to the colon wall. In this paper, we present a pressure-sensing sleeve that has been developed to provide real-time pressure monitoring during colonoscopy training on a simulator. This can be used along with movement tracking of the simulator colon and three-dimensional shape estimation of the colonoscope using electromagnetic tracking for training purposes. The sensing modalities complement each other and provide the trainee with real-time visual feedback on the section of the colonoscope transmitting the pressure to the colon during a simulated colonoscopy procedure. The pressure data, the colon movement data, and the position and the quality of advancement of the scope through the colon are used to objectively evaluate the trainee’s performance using the metrics described in this paper. Such a training environment can help in providing the necessary skills to trainees while keeping the transmitted pressure within safe limits to minimize patient discomfort and maximize safety.