Colorectal cancer is the second largest “cancer killer” in the U.S. with more than 100,000 deaths each year. This is despite the 15 million colonoscopies performed annually throughout the country. The procedure is performed to early detect and treat colorectal cancer. Unfortunately, over 20 million adults who fall into the at-risk category fail to get this recommended and preventative examination. Why is this the case? We reached out to medical professionals to find out, and to discover where 3D fiber optic shape sensing technology could help.
Despite being minimally invasive, colonoscopies are often associated with significant patient discomfort due to inherent navigation challenges. As a result, those performed in the U.S. typically involve patient sedation. This is done to minimize discomfort and reduce duration; however, it adds preparation time, cost, and comes with its own set of potential side effects. Sedation is less common outside of the U.S., resulting in greater concern and more frequent occurrence of distress during the examination. Thus, whether sedation is involved or not, many people choose to avoid the procedure altogether. It is clear that innovations which accelerate and simplify the process and improve patient comfort would lead to more people choosing to receive these preventative screenings.
A gastroenterologist will most often perform a colonoscopy. Unfortunately, the gastrointestinal community is not immune to the growing physician shortage in the U.S., which is projected to be 1,630 by 2025. The lack of practitioners, coupled with the recent lowering of the recommended age from 50 to 45 for screenings, is driving patient wait times for routine colonoscopies up to a year in some parts of the country.
Despite the number of first-year fellows entering gastroenterology as a subspecialty having steadily increased each year since 2011, a significant deficit in gastroenterologists remains. Even if the unaddressed patient population of 20 million could be convinced to get a colonoscopy, they would likely need to wait several years to receive one with the added demand on the already taxed supply of available physicians.
Training for colonoscopies tends to take place in massed learning lessons in the US. This ultimately results in reduced exposure and practice, with a minimum of only 50 procedures to be performed by each medical professional prior to certification. There is an opportunity to improve the quality and rate of certification in the U.S. and abroad to mitigate physician shortage and address current and future patient populations.
Most colonoscopes in use today are multi-use devices which must be carefully and thoroughly sterilized between patients. Previously, it was thought that infections post- procedure was one in a million. Recent research by John Hopkins University shows that the rate of infection within seven days of a screening colonoscopy is higher than 1 in 1,000 patients. This issue has led to increased ridicule by the Food and Drug Administration and has generated pressure to innovate within the medical device community.
For example, several single-use disposable colonoscopes have recently been commercialized and approved for use in the U.S. The single-use method is quickly garnering the attention of those in the medical field, as it eliminates the risk for cross-contamination, requires a lower level of training, and is more cost-effective. Several organizations are looking to utilize robotics to address risks and other gaps in this field. Innovators are actively seeking to improve and expand on these solutions to further drive down the risks and costs associated with colonoscopies.
How Can 3D Fiber Optic Shape Sensing Help?
Colonoscopes are equipped with cameras which allow the physician to view the anatomy as the device passes through the colon. There are also measurement markers to identify how far the device has been inserted. Varying anatomy and looping, a common issue within the procedure, creates navigational issues in which the device response does not match the expected response based on the camera visual and known insertion length.
A colonoscope equipped with 3D fiber optic shape sensing technology delivers improved navigation capability to overcome this challenge. The 3D shape reconstruction of the entire device length shows the operator the exact device response in real-time, leading to shorter, simpler, safer, and more comfortable procedures. The technology also enhances and expedites the instructional process. The added visualization of the device’s 3D shape enables medical students to both see and feel what is happening to the entire colonoscope throughout the procedure, increasing the value of each colonoscopy performed in training.
Finally, The Shape Sensing Company has developed a 3D fiber optic shape sensing solution that has the potential to be scalable for both the procedural volume and the single-use disposable costing needs of this market.
In summary, 3D fiber optic shape sensing can help win the fight against colorectal cancer by enabling access to more at-risk patients for colonoscopy screenings. Challenges surrounding this field are being faced head on by The Shape Sensing Company’s technology in a way that has never been done before. We want to help at-risk individuals and ultimately reduce the impact colorectal cancer is having on our communities by providing a less invasive, risky, costly, and time-consuming colonoscopy procedure.