| [ Summary ] |
A fundamental insertion technique for colonoscopy by one operator was described. This particular technique is performed by shortening the colonic fold through bending. We can classify the insertion pattern for the sigmoid colon roughly into three types. The scope reaches the junction of the sigmoid and the descending (SD-j) colon 25cm from the anal verge(AV) to SD-j, if the operator can thoroughly shorten the any type of sigmoid colon. An expert needs only two to five minutes to reach the caecum with a type A sigmoid colon, which is the simplest type. The sigmoid colon takes it's route to left as seen on the monitor, in type B colons. The operator should perform a maneuver of turning the direction of colon from left to right with this type. The type C pattern indicates a redundant sigmoid colon. It is not easy to reach the SD-j by moving the 25cm distance from the AV. The operator must master many maneuvers (hooking the fold, right turn shortening technique, abdominal manipulations, etc.) to perform the shortening the redundant sigmoid colon. The operator should master fundamental insertion techniques through repeated examinations. |