Painless robotic colonoscopy for detecting and preventing bowel cancer

Colorectal cancer (CRC) is a serious disease, has the third most prevalent cancer incidence and is second for cancer-related deaths, with almost 1 million deaths per year. Most of these CRCs develop from colonic polyps, which can be present for years before the development of the CRC. Their detection is therefore critical.

colonoscopy allows both the identification and removal of colonic polyps during a single procedure

It is estimated that the removal of polyps is associated with a 60% reduction in CRC- related deaths. In this regard, colonoscopy allows both the identification and removal of colonic polyps during a single procedure.

Combined diagnosis and treatment

Lower gastrointestinal endoscopy is considered the gold standard for the diagnosis and removal of colonic polyps. If there is any delay in colonoscopy following a positive stool test this will increase the likelihood of advanced CRC occurrence. However, patients may refuse to undergo conventional colonoscopy (CC) due to fear of possible risks and pain or discomfort. In this regard, patients undergoing CC frequently require sedation to better tolerate the procedure, increasing the risk of deep sedation or other complications related to sedation. Accordingly, the use of CC as a first-line screening strategy for CRC is hampered by patients’ reluctance due to its invasiveness and anxiety about possible discomfort.

To overcome these limitations, researchers and investigators, including Dr Premchand in the UK, have investigated the use of robotic colonoscopy (RC). Self-propelling robotic colonoscopes are highly flexible and adapt to the shape of the lower gastrointestinal tract, allowing a virtually painless examination of the colon. The first painless robotic colonoscopy clinic went live in UK in May 2023.

Aternative procedures to CC and RC include:

  • barium enema (BE),
  • computed tomographic colonography (CTC), and
  • colon capsule endoscopy (CCE).

However, these are purely diagnostic procedures and are limited by the need for subsequent investigations whenever suspicious lesions are found. Therefore a follow-up treatment procedure will also be required following CTC and CCE.

A colonic robot designed by nature

RC systems clearly mark a major advance in endoscopy. The new endoscopes are painless as they use a method of locomotion to adapt to the shape of the lower gastrointestinal tract, which reduces pressure on the colonic walls. This also reduces any risk of perforation and removes the need for sedation.

Studies demonstrate that robotic colonoscopes can provide a far more comfortable alternative to standard colonoscopy. The only RC system that is currently available for use in clinical practice is the Endotics System that although now in use in other hospitals in Europe, has been pioneered in the UK by Consultant Gastroenterologist, Dr Prem Premchand at his NHS Trust hospital.

The pioneering and innovative robotic colonoscopy (RC) represents the future of quality medical care. Following the launch at the RBH Trust, this is not a service that is widely available across the UK yet – although it is likely to be so at some point in the near future.

RC is a massive step forward as this technology allows the following fundamental patient and hospital benefits:

  1. Painless, and so patients who could not otherwise tolerate the procedure can now be diagnosed and treated.
  2. No sedation means that recovery facilities and staff are not required.
  3. Disposable units – means no requirement for decontamination, radically reducing staff costs and removing need for expensive facilities.
  4. Patient safety, as the device does not require forceful pressure, risk of perforation is reduced.
  5. The procedure will become available on an OP basis.


Diagnostics, MDPI, 

Robotic Colonoscopy and Beyond: Insights into Modern Lower Gastrointestinal Endoscopy

Emanuele Tumino 1, Pierfrancesco Visaggi 1,2,* , Valeria Bolognesi 1, Linda Ceccarelli 2, Christian Lambiase 2,

Sergio Coda 3, Purushothaman Premchand 3, Massimo Bellini 2 , Nicola de Bortoli 2 and Emanuele Marciano 1

A barium enema is a medical procedure used to examine and diagnose problems with the colon (large intestine). X-ray pictures are taken while barium sulphate fills the colon via the rectum. Full medical glossary
Abnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
The large intestine. Full medical glossary
Examination of the colon and rectum with a colonoscope, an imaging instrument that is inserted through the anus. Full medical glossary
A condition that is linked to, or is a consequence of, another disease or procedure. Full medical glossary
The abbreviation for computed tomography, a scan that generates a series of cross-sectional x-ray images Full medical glossary
The process of determining which condition a patient may have. Full medical glossary
A tube-like viewing instrument that is inserted into a body cavity to investigate or treat disorders. Full medical glossary
Examination of the inside of the body using a tube equipped with a light source and either a small camera or an optical system. Full medical glossary
The introduction of a liquid into the bowel via the anus either to deliver a drug or to wash out the contents of the rectum. Full medical glossary
The gut, which begins at the mouth and ends at the anus. Full medical glossary
The number of new episodes of a condition arising in a certain group of people over a specified period of time. Full medical glossary
relating to the intestines, the digestive tract between the stomach and the anus Full medical glossary
a general term to cover any abnormality such as a wound, infection, abscess or tumour. Full medical glossary
The formation of a hole in an organ or tissue. Full medical glossary
A growth on the surface of a mucous membrane (a surface that secretes mucus, lining any body cavity that opens to the outside of the body). Full medical glossary
Growths on the surface of a mucous membrane (a surface that secretes mucous), lining any body cavity that opens to the outside of the body. Full medical glossary
Relating to the rectum, the lowest part of the bowel leading to the anus. Full medical glossary
A way to identify people who may have a certain condition, among a group of people who may or may not seem to Full medical glossary