| [ Summary ] |
The success rate for total colonoscopy is higher than 99%. The reasons for insertion failure were colonic diverticular disease, postoperative adhesions and long colons. In this article the insertion technique for difficult cases, especially concerning passage of the hepatic flexure, were mentioned. There is no special insertion method, but the examiner can use ordinary techniques. Important points are air suction, deep breathing and sedative drugs, which help with abdominal relaxation. To preventing colonic loop formation, the mini-sliding tube, abdominal manipulation, and patient posture alteration are useful. The necessity of changing the scope type is very rare. The most important point for improving insertion rate is to select adequate techniques, considering the patient and scope status. |