| 特集名 | Total colonoscopy -- 挿入理論とその応用 | |
|---|---|---|
| 題名 | 挿入困難例とその克服方法 (4) 肝彎曲部から盲腸まで a. 挿入法のポイント | |
| 発刊年月 | 2003年 09月 | |
| 著者 | 井上 雄志 | 東京女子医科大学消化器病センター |
| 著者 | 手塚 徹 | 東京女子医科大学消化器病センター |
| 著者 | 篠原 知明 | 東京女子医科大学消化器病センター |
| 著者 | 中村 哲夫 | 東京医科大学第四内科 |
| 著者 | 塚田 百合子 | 東京女子医科大学消化器病センター |
| 著者 | 加藤 博士 | 東京女子医科大学消化器病センター |
| 著者 | 羽村 公代 | 東京女子医科大学消化器病センター |
| 著者 | 大井 至 | 東京女子医科大学消化器病センター |
| 著者 | 高崎 健 | 東京女子医科大学消化器病センター |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Theory of insertion technique in total colonoscopy and its practical application | |
|---|---|---|
| Title | Insertion of colonoscope from hepatic flexure to the ascending colon | |
| Author | Yuji Inoue | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Toru Tezuka | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Tomoaki Shinohara | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Tetsuo Nakamura | The Fourth Department of Internal Medicine, Tokyo Medical University |
| Author | Yuriko Tsukada | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Hiroshi Katoh | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Kimiyo Hamura | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Itaru Ooi | Institute of Gastroenterology, Tokyo Women's Medical University |
| Author | Ken Takasaki | Institute of Gastroenterology, Tokyo Women's Medical University |
| [ Summary ] | We explain the insertion of the colonoscope from the hepatic flexure of the transverse colon to the ascending colon. The basic procedure is as follows: after passing the central part of the trans verse colon, the shape of the scope is manipulated using paradoxical advancement while aspirating air. It is then inserted into the ascending colon while rotating it to the right. In cases in which this is difficult (e.g. cases of adhesion after abdominal surgery), it is inserted using the following techniques. 1) The patient is asked to breathe in and out deeply. 2) In the case of a variably rigid colonoscope the degree of rigidity is lowered to 0. 3) Using manual pressure, the colonoscope is inserted into the ascending colon in an M shape. 4) With the patient in the left lateral position, any air is further aspirated and the colonoscope is maneuvered into the ascending colon. Of course, in many cases a combination of these techniques is effective. |
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