P234 Patient and endoscopist perceptions of new technologies in colonoscopy

Introduction

Colonoscopes have advanced in their imaging capabilities, but the cogs/wheels push-pull actuation is grossly similar to the first devices over 50 years ago. Recent advances in robotics and miniaturisation, has led to increasing research in robotic colonoscopy. A device that can navigate the colon using alternative actuation methods to conventional colonoscopy has a lot of potential benefits. Less pressure on the mesentery could improve discomfort, reducing sedative use and time in departments. No torquing and no wheels could reduce musculoskeletal injuries in endoscopists. Surgical robotics has been well received by patients and physicians. We wish to explore patient and endoscopist perceptions of new technologies and robotics in colonoscopy.

Methods

Using inductive interpretative/constructionist qualitative research methods we explore the perceptions of robotics in colonoscopy in patients and endoscopists. Recruitment was via advertising on social media, charity websites and email. Focus groups and interviews were conducted by one researcher, a Gastroenterology Research Fellow. A semi-structured format was used to perform focus groups and interviews, with questions initially generated from an understanding of the subject. Thematic analysis was performed consecutively, with the interview questions evolving as themes emerged. Data collection continued until a saturation of new information was achieved.

Results

A patient focus group contained 11 participants, and 4 in the endoscopist focus group. Thirty patient and 8 endoscopist interviews were conducted. Preliminary analysis of the nodes generated and some quotes are included below. 1. Enthusiasm • Could be a ‘game changer’ • ‘…must be under constant human supervision’ • Concern about artificial intelligence being allowed to perform procedure without human supervision. • ‘It would actually improve my feelings of confidence’ • Could reduce training time • Could reduce injuries • Conventional colonoscope not designed for small hands • ‘Patients seem to prefer robotic surgery so it shouldn’t be an issue’ • Some may not wish to retrain on a new device. • Will need a lot of data proving safety and efficacy. • Cost could affect adoption

Conclusions

The preliminary analysis of this qualitative data suggests both patients and endoscopists are likely to be accepting of a robotic alternative to conventional colonoscopy, provided it meets similar quality standards to conventional colonoscopy. Concern exists around unmanned autonomous navigation in robotic devices. Several barriers to adoption at an endoscopist and departmental level have been highlighted including need for robust clinical trial data, ease of training and cost.