| 特集名 | 最新の大腸内視鏡と挿入法の進歩 | |
|---|---|---|
| 題名 | 硬度可変式大腸内視鏡の臨床 (4) 軟らかい機器による検査の実際 -- 硬度可変式細径大腸内視鏡によるtotal colonoscopyのコツ | |
| 発刊年月 | 2001年 02月 | |
| 著者 | 大政 良二 | 大政クリニック |
| 【 要旨 】 | 硬度可変式細径大腸内視鏡を使用して検査を行うときの，硬度を変える具体的な目安について解説した．軟の硬度に調整して検査を行うときの長所:(1) プッシュ主体の挿入法に適し，大腸内視鏡の経験の少ない初心者でも安全に操作できる，(2) SD－junctionの通過など急峻な屈曲部を通過して挿入を行うのが容易である．硬い硬度で使用するときの長所:スコープの捻りの追従性が良いため，腸管短縮を主体とする挿入法，S状結腸の直線化の保持や深部挿入を行うときに生じるS状結腸の再ループ形成の予防に有効である．ただし硬度調整ノブを軟から硬い状態に調整するときに抵抗があり，被検者が強い苦痛を訴える場合には無理なループができていることがあり，軟から硬い状態にしてはいけない． | |
| Theme | Latest Developments in Devices Related to Colonoscopy and Progress in Insertion Techniques | |
|---|---|---|
| Title | The Art of Total Colonoscopy using Variable Stiffness Colonoscope (CF-240A) | |
| Author | Ryoji Omasa | Omasa Medical Clinic |
| [ Summary ] | The variable stiffness colonoscope (CF-240 A) is a very usefull tool, because the stiffness of the CF-240 A's insertion scope can be easily adjusted during the insertion operation, depending upon physicians' needs. In the case of examinations with the CF-240 A, we started to insert the shaft with the softer mode and continued insertion, using the same mode, until progress was halted. If we have trouble going further than the SD junction, because of loops being formed at the sigmoid colon, we release the loops and straighten the inserted portion. Then, we change the variable stiffness mode of the shaft from the softer to the harder and insert the scope further. Advantages attributed to the softer mode. : (1) It was easy to release loops formed at the sigmoid colon when the distal end of the scope reached the splenic flexure. (2) Since delicate operation of scope movement is possible, observing inside the colon with a scope in the softer mode was easier than with a scope in the harder mode (during withdrawal of the scope). (3) It was indicated that relatively safe insertion operation was possible, even in cases of inserting a scope into a colon with stenosis, diverticulosis, post abdominal operation adhesions etc. Advantages attributed the harder mode. : (1) Preventing loops of the inserted portion, formed at the sigmoid colon, when inserting a scope from the splenic flexure to the transverse colon, making it no longer necessary to conduct procedures in combination with the sliding tube, abdominal manipulation and patient posture change. Insertion into a colon having strong spasms was facilitated. |
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