FACILITATED COLONOSCOPY

COLONOSCOPY IS WELL ESTABLISHED AS THE DEFINITIVE DIAGNOSTIC PROCEDURE WHEN MALIGNANCY OF THE LARGE INTESTINE IS SUSPECTED. THERE IS EXCELLENT EVIDENCE THAT ALL OR NEARLY ALL COLONIC MALIGNANCY BEGINS IN PREVIOUSLY BENIGN POLYPS. IF THESE COULD BE REMOVED WHILE STILL BENIGN, MOST COLON CANCER WOULD BE PREVENTED. COLONOSCOPY, HOWEVER, REQUIRES A HIGH DEGREE OF SKILL TO PERFORM, IS COSTLY, AND POSES A RISK OF PERFORATION OF THE COLON. DISCOMFORT TO THEPATIENT CAN BE SIGNIFICANT AS WELL, WITH ANESTHETICS FREQUENTLY REQUIRED. THE PROBLEMS STEM MAINLY FROM THE DIFFICULTIES OF INSERTING THE COLONOSCOPE, THE MOST TIME CONSUMING AND RISKY PORTION OF THE PROCEDURE. A NOVEL MODIFICATION TO COLONOSCOPY IS PROPOSED FOR DEVELOPMENT WHICH, IF VALID, WOULD SO FACILITATE COLONOSCOPEINSERTION AS TO REVOLUTIONIZE THE PROCEDURE BY REDUCING ITS RISK, DISCOMFORT, AND COST. THE PROCEDURE COULD BE OFFERED AS A SCREENING STUDY, DRASTICALLY ALTERING THE RISK OF COLONCANCER. PHASE I WILL DEMONSTRATE THE NEW PROCEDURE IN SIMULATED COLONS, ANIMAL INTESTINES, AND FINALLY IN DOGS. CLINICAL DEMONSTRATION WOULD BE ACCOMPLISHED IN A PHASE II FOLLOW-UP.