INTESTINE Vol.24 No.2(2-1)

Theme Painless colonoscopy insertion method -- technique & device
Title "Straightening and Shortening Method" as a fundamental basic technique of colonoscope insertion
Publish Date 2020/06
Author Hiro-o Yamano Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine
Author Shinji Yoshii Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine / Gastrointestinal Endoscopy Center, Sapporo Medical University Hospital
Author Hiroshi Nakase Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine
[ Summary ] The large intestine is a luminal organ with a wide variety of shapes and a high degree of flexibility and elasticity. Its complexity and differences from one individual to another make it very difficult to learn and practice the technique of colonoscope insertion. In 1997, Professor Kudo proposed the "Straightening and Shortening Method" as a fundamental basic technique of colonoscope insertion. I have practiced this method as one of his disciples and based on my experience, I believe this method consists of two components in terms of strategy and tactics. The first component is to always hold and restore the colonoscope on the "axis" line during insertion. The "axis" is a virtual line that connects five fixed points in the abdominal cavity: the cecum, hepatic flexure, splenic flexure, sigmoid-descending junction, and rectum. The second component involves local scope manipulation. The colonoscope is manipulated into various bends and loops, restored to a straight line, and ultimately repositioned on the "axis" by repeating the manipulation. In this paper, I have shown and explained this method with on the desk and actual Endoscope Position Detecting Unit images.
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