| Theme | Latest Developments in Devices Related to Colonoscopy and Progress in Insertion Techniques | |
|---|---|---|
| Title | Changes in Endoscopic Insertion Techniques | |
| Publish Date | 2001/02 | |
| Author | Hirohumi Niwa | St. Marianna University Scool of Medicine |
| [ Summary ] | Constant changes and improvements have been made on the insertion techniques for colono-fiber scopes and videoscopes. Changes in major insertion techniques from the various developments were analyzed. It is difficult to advance the fiberscope just by pushing it under direct vision only, because the colon extends longitudinally. In order to pass the most difficult section, which is the sigmoid colon, Tajima invented the α-turn insertion method. Even after the scope has entered the descending colon and become straight, the sigmoid colon tends to form a loop. This makes it difficult for the tip of the scope to advance deeper into the colon. In order to reach the deeper area of the colon it is important to maintain the scope in a straight line without forming a loop. To prevent this looping, there are methods, such as the steel wire insertion method (Deyhie, et al.). In this method a steel wire is inserted into the biopsy channel to increase the stiffness. The sliding tube method (Makiishi, et al.) is still being used today. In this method a tube is applied over the scope. After the sigmoid colon and the descending colon are straightened, the tube is gradually pushed into the descending colon to prevent re-looping. There have been various alterations made on the sliding tubes. There is one type that can be separated. Other methods include the rope-way method, the end-to-end method, and colon guidance by the string method. The importance of keeping the colon straight, during insertion was recognized for some time. Therefore, the significance of the insertion method of colonic fiberscopes was mainly focused on how to straighten the colon and how to maintain it. Currently, devices such as variable stiffness colonoscopes and a magnetically operated device, that can locate the scope inside the colon have been developed to further facilitate the procedure. |
|