Leading expert in colorectal cancer screening and virtual colonoscopy, Dr. Perry Pickhardt, MD, explains how CT colonography offers a superior patient experience compared to traditional optical colonoscopy. He details the easier, low-volume bowel preparation and the procedure itself, which requires no sedation or IV. Dr. Perry Pickhardt, MD, highlights the rapid recovery, immediate results, and significantly lower complication rate. His program's unique one-stop-shop approach allows for same-day polyp removal when needed, minimizing patient inconvenience.
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Virtual Colonoscopy vs. Traditional Colonoscopy: A Patient Experience Comparison
Jump To Section
- Easier Preparation Process
- Procedure Details and Comfort
- Rapid Recovery and Results
- Safety and Complication Rates
- Integrated One-Stop Screening
- Patient Preference Data
- Full Transcript
Easier Preparation Process
Virtual colonoscopy preparation is significantly less demanding for patients. Dr. Perry Pickhardt, MD, explains that CT colonography uses a much lower volume bowel preparation compared to the standard 2 to 4-liter preps required for optical colonoscopy. This smaller prep volume is combined with oral contrast agents. These agents tag any residual fluid and material inside the colon, which actually increases the diagnostic accuracy of the CT scan.
Procedure Details and Comfort
The virtual colonoscopy procedure itself is designed for maximum patient comfort and convenience. Dr. Perry Pickhardt, MD, emphasizes that no intravenous line is needed, and the exam is performed without any sedation or medications. The entire CT colonography scan is completed quickly, typically lasting only 10 to 15 minutes. From the patient's perspective, it feels like a routine CT scan, eliminating the anxiety associated with invasive procedures and sedation.
Rapid Recovery and Results
Recovery after a virtual colonoscopy is immediate, allowing patients to return to normal activities right away. Dr. Perry Pickhardt, MD, notes that there is no prolonged recovery period, and patients do not need a designated driver. Results from the CT colonography are provided with a very fast turnaround, usually within 1 to 2 hours. Patients are contacted directly, often by mobile phone, and can receive their results anywhere, from work to the golf course.
Safety and Complication Rates
The safety profile of virtual colonoscopy is a major advantage over the traditional method. Dr. Perry Pickhardt, MD, states that the complication rate for optical colonoscopy is considerably higher. In contrast, his extensive CT colonography screening program has experienced no significant complications throughout its history. This enhanced safety, combined with the non-invasive nature of the scan, makes it a very low-risk option for colorectal cancer screening.
Integrated One-Stop Screening
A key benefit of Dr. Pickhardt's program is its integrated, one-stop-shop approach. He works closely with gastroenterologists to streamline care. When a large polyp or cancer is detected on a virtual colonoscopy, the patient can undergo a therapeutic optical colonoscopy for polyp removal on the same day. This efficient system means that fewer than 10% of patients require both tests, and they only need to complete a single bowel preparation.
Patient Preference Data
Patient preference data consistently shows a strong favor for virtual colonoscopy. Dr. Perry Pickhardt, MD, reports that every patient survey and questionnaire conducted by his team has revealed a very strong preference for CT colonography over regular colonoscopy. The combination of an easier prep, a more comfortable procedure, immediate recovery, and rapid results makes the overall patient experience with virtual colonoscopy vastly superior. Dr. Anton Titov, MD, concurs that this makes the procedure exceptionally convenient from the patient's perspective.
Full Transcript
Dr. Anton Titov, MD: Preparation for CT colonography is easier than preparation for regular colonoscopy. How does patient experience during CT colonography compare with traditional colonoscopy?
Dr. Perry Pickhardt, MD: We tend to use a much lower volume bowel preparation for virtual colonoscopy. This is different from gastroenterologists, who continue to use 2 and 4 liter bowel preparations for regular colonoscopy.
We tend to use a tiny fraction of that prep volume, but we also include oral contrast. It is used to tag residual fluid and material at CT, which increases accuracy of virtual colonoscopy.
The preparation the night before virtual colonoscopy is easier. Patients come in and there is no intravenous line needed. We do not use any medications; there are no needles, no sedation.
The virtual colonoscopy exam itself lasts 10 to 15 minutes at the most. A regular optical colonoscopy is different.
You undergo a much more rigorous bowel preparation the night before. An intravenous line is started before the procedure. They basically sedate you to the point where most people are sleeping.
This is probably a good thing for patient convenience or acceptance, but the recovery time after regular colonoscopy is prolonged. Patients need to have a second person to drive them home after regular colonoscopy.
The complication rate of regular optical colonoscopy is considerably higher. We have had no significant complications in the experience of our entire CT colonography screening program history.
The experience for patients undergoing virtual colonoscopy is easy. It is a small bowel preparation before the procedure, but virtual colonoscopy is just a routine CT scan from a patient's perspective.
Virtual colonoscopy is a CT scan, that is true. The added benefit to our program is this: not all CT colonography programs have achieved this.
We work closely with our gastroenterologists. When we find a large polyp or a cancer, we actually send the patient on for optical colonoscopy to remove the polyp on the same day.
Patients only undergo a single preparation. That is done in fewer than 10% of all patients who undergo virtual colonoscopy. It is a one-stop shop for the minority that are harboring significant pathology or potential colon cancer.
Dr. Anton Titov, MD: But the vast majority of patients avoid the more invasive test of regular colonoscopy. It is 90% or more patients. They can essentially go back to their regular activities as soon as they hear the results of CT colonography.
Dr. Perry Pickhardt, MD: We provide results of virtual colonoscopy usually within 1 to 2 hours at the most. This is our time window of returning the results of virtual colonoscopy to our patients. It is a very fast turnaround for virtual colonoscopy procedure.
The anxiety of the patients waiting for the results is an important factor. After patients undergo virtual colonoscopy, they are free to go wherever they want.
We just contact them usually by mobile phone and tell them the results of the test. Patients could be at work or on the golf course. Patients don't eat or drink before we tell them results of virtual colonoscopy.
They are able to come back for the colonoscopy in the small percentage that need the second test.
Dr. Anton Titov, MD: Clearly that makes the virtual colonoscopy procedure very convenient from a patient's perspective.
Dr. Perry Pickhardt, MD: Yes, and that is what we've seen repeatedly in our polling and our questionnaires to patients.
Dr. Anton Titov, MD: There has been a very strong preference for CT colonography over regular colonoscopy. This is true every time we have conducted such a survey.