Use of an Abdominal Compression Device in Colonoscopy: A Randomized, Sham-Controlled Trial

Abstract

Background & aims: Looping is a common problem during colonoscopy that prolongs procedure time. We aimed to determine the efficacy and safety of ColoWrap, an external abdominal compression device, with respect to insertion time and other procedural outcomes.

Methods: We performed a prospective study of outpatients undergoing elective colonoscopy (40-80 years old; mean age, 60.5 years) at endoscopy facilities in the University of North Carolina Hospitals from April 2013 through March 2014. Subjects were randomly assigned to groups that received either ColoWrap (n = 175) or a sham device (control, n = 175) during colonoscopy. Colonoscopists and staff were blinded to the application. The primary outcome was cecal intubation time (CIT). Secondary outcomes included use of manual pressure and position change.

Results: The mean CIT was similar for the control and ColoWrap groups (6.69 vs 6.67 minutes; P = .98). There were no statistical differences in the frequency of manual pressure (45% for controls vs 37% for ColoWrap group, P = .13) or position changes (4% for controls vs 2% for ColoWrap group, P = .36). Among patients with body mass index between 30 and 40 kg/m(2) (n = 78), CIT was significantly lower for patients in the ColoWrap group (4.69 minutes) than controls (6.10 minutes) (P = .03). Adverse events were similar between groups.

Conclusions: In patients undergoing elective colonoscopy, application of an external abdominal compression device did not improve CIT or affect the frequency of ancillary maneuvers. A possible benefit was observed in patients with body mass index between 30 and 40 kg/m(2), but further studies are needed. ClinicalTrials.gov number: NCT02025504.

Keywords: Abdominal Binder; BMI; Difficult; Nursing.

Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Study flow chart showing flow of participants through trial.

Figure 2

Box and whisker plots of cecal intubation time for ColoWrap and sham arms overall for intention to treat analysis (A), for participants with class I–II obesity (B), and per-protocol analysis (C).

Figure 2

Box and whisker plots of cecal intubation time for ColoWrap and sham arms overall for intention to treat analysis (A), for participants with class I–II obesity (B), and per-protocol analysis (C).

Figure 2

Box and whisker plots of cecal intubation time for ColoWrap and sham arms overall for intention to treat analysis (A), for participants with class I–II obesity (B), and per-protocol analysis (C).