| [ Summary ] |
In 1957, the "sigmoidocamera" was developed in our Institution. With this method, a patient did not undergo sedation. Since then, colonoscopy without sedation has been performed. In order to minimize abdominal pain during colonoscopic insertion, the alpha loop maneuver technique was introduced. However, in some patients we could not make an insertion into the proximal colon because of severe abdominal pain, even when this method was used. Colonoscopy for patients who have had previous abdominal surgery, those with diverticular disease, women and those of advanced age is technically difficult, even in expert hands, and usually induces abdominal pain if sedative agents are not administered. One way of preventing pain during colonoscopy is to use a scope that is more flexible and thinner than conventional scopes. Recently, an extra-flexible, small-diameter colonoscope (CF-SV, Olympus Inc., 9.6mm in diameter with a 103cm working-length) was developed in order to improve patient safety and comfort. A comparative study showed that fewer unsedated patients felt pain during colonoscopy with the CF-SV, than with a conventional colonoscope. The use of the CF-SV can avoid overextension of the sigmoid colon, even with a loop. This colonoscope can be inserted as far as the descending colon, without causing pain, due to overextension of the sigmoid colon. Sedative agents and the right turn shorting technique are not necessary when this new type of colonoscope is used. |