Clin Colon Rectal Surg 2001; 14(4): 331-336
DOI: 10.1055/s-2001-18512
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Technical Pearls

James M. Church
  • Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH
Further Information

Publication History

Publication Date:
19 November 2001 (online)

ABSTRACT

Colonoscopy is perhaps the most important investigation available to physicians who care for patients with diseases of the large intestine. Indications for colonoscopy are common, and it is arguably the most cost-effective way of screening for colorectal cancer. The demand for colonoscopy is likely to increase, leading to an increased demand for colonoscopists. Every colonoscopist has to acquire and develop skill in the technique of intubating the colon, a technique that is difficult to learn and even more difficult to do well. The stakes are high as the insertion technique plays a major role in the effectiveness and the acceptability of colonoscopy, whereas the withdrawal technique determines clinical accuracy. Other articles in this volume cover important topics related to the procedure such as bowel preparation, medication, therapeutics, training, and complications. This article provides some ideas that may be helpful in refining the colonoscopy insertion technique itself.

REFERENCES

  • 1 Hull T, Church J M. Colonoscopy; how difficult, how painful.  Surg Endosc . 1994;  8 784-787
  • 2 Waye J D, Yessayan B A, Lewis B S. The technique of abdominal pressure in total colonoscopy.  Gastrointest Endosc . 1991;  37 147-151
  • 3 Webb W. Colonoscoping the ``difficult'' colon.  Am Surg . 1991;  57 178-182
  • 4 Rex D K, Imperiale T F, Portish V. Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial.  Gastrointest Endosc . 1999;  49 554-559
  • 5 Graber R G. Propofol in the endoscopy suite: an anesthesiologist's perspective.  Gastrointest Endosc . 1999;  49 803-806
  • 6 Forbes G M, Collins B J. Nitrous oxide for colonoscopy: a randomized controlled study.  Gastrointest Endosc . 2000;  51 271-277
  • 7 Saifuddin T, Trivedi M, King P D. Usefulness of a pediatric colonoscope for colonoscopy in adults.  Gastrointest Endosc . 2000;  51 314-318
  • 8 Farmer K CR, Church J M. Open sesame; tips for traversing the anal canal.  Dis Colon Rectum . 1992;  35 1092-1093
  • 9 Church J M. Ancillary colonoscope insertion techniques; an evaluation.  Surg Endosc . 1993;  7 191-193
  • 10 Haseman J H, Lemmel G T, Rahmani E Y. Failure of colonoscopy to detect colorectal cancer: evaluation of 47 cases in 20 hospitals.  Gastrointest Endosc . 1997;  45 451-455
  • 11 Miller B J, Cohen J R, Theile D E. Diagnostic failure in colonoscopies for malignant disease.  Aust NZ J Surg . 1998;  68 331-333
  • 12 Anderson M L, Heigh R L, McCoy G A. Accuracy of assessment of the extent of examination by experienced colonoscopists.  Gastrointest Endosc . 1992;  38 560-563
  • 13 Rex D K, Cutler C S, Lemmel G T. Colonoscopic miss rate of adenomas determined by back-to-back colonoscopies.  Gastroenterology . 1997;  112 24-28
  • 14 Rex D K. Colonoscopic withdrawal technique is associated with adenoma miss rates.  Gastrointest Endosc . 2000;  51 33-36