EP661 - Use of SmartDevices in Diagnosis of Benign Colorectal Disease: A Case Report and Literature Review

Image or Table (Do Not add text here):

Purpose/Background: The use of smartwatches and “wearables” is an intriguing development in health care. Patients are able to monitor and trend their own vitals, activity levels, and sleep patterns from the comfort of their daily lives. We briefly discuss a case of a patient whose smartwatch prompted diagnostic imaging for a clinically undetectable peri-rectal abscess. Review of the literature focuses on how wearables are utilized in the field of colorectal surgery and we propose future directions for best-practice uses.

Methods/Interventions:

Case Report: This is a 51 year old male who initially came to clinic with complaints of 5 days of perianal pain. His physical exam was unremarkable and was sent home. By use of his smartwatch, he noted that his heart-rate variability had decreased and he continued to have pelvic pain, which prompted further work-up with pelvic MRI. He was found to have a large 9.5cm horseshoe abscess. After drainage of the infection, his smartwatch recorded return to his baseline heart rate range and heart rate variability (Figure 1)

Results/Outcomes: Literature Review: Wearable technology has been well documented within the clinical and research settings to aid in perioperative monitoring. Tracking physiological changes in real time confers greater accuracy and closer monitoring of patients. Although telemetry monitoring is commonplace in many healthcare facilities for monitoring electrophysiological changes, the promise of wearable technology would allow for a similar degree of monitoring from home. Currently, many consumer wearable devices have been shown to provide information about heart rate, respiratory rate and physical activity levels. Real-time monitoring of heart rate variability and oxygen saturation are additional capabilities that are not as widely reported.

The use of wearable data has already begun to be investigated to aid in evaluating preoperative fitness levels. Multiple studies have also been published that used consumer smartwatches to monitor patients with COVID. Physical activity levels have also been investigated by orthopedic and thoracic surgeons in an effort to improve same-day discharges. Using wearable monitors to track patient activity levels, it was found that patient education and encouragement towards physical activity led to decreased pain scores and improved patient activity tolerance. Regarding abdominal surgeries, there are emerging studies showing how the development of mobile apps and smartwatches can be utilized to aid in same-day discharges after colectomy.

Conclusion/Discussion: Wearable technology is becoming more ubiquitous and easily accessible. Our case demonstrates how this technology detected deviations from a patient’s baseline health and aided in the diagnosis of a perianal abscess. The use of Smartwatches will be a useful adjunct in the perioperative monitoring of colorectal patients. The continued development of this technology will allow advances to same-day discharge after colectomy, and hopefully aid in the prevention of post-op complications or infections from the comfort of patient’s homes.