| Theme |
Theory of insertion technique in total colonoscopy and its practical application |
| Title |
Total colonoscopy using a colonoscope with a normal stem |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Tadateru Hasuo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Masanori Sakashita |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yoshiro Tamegai |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Non loop insertion techniques for colonoscopy are less invasive than other techniques. This particular technique is performed by shortening the colonic fold. We can classify the insertion pattern for the sigmoid colon into three types. In pattern A, the scope reaches the junction of the sigmoid and the descending (SD-j) colon 25cm from the anal verge (AV) to the SD-j. An expert needs only two minutes or less to reach the cecum in pattern A cases. The sigmoid colon is routed to the left as seen on the monitor, in pattern B cases. The operator should perform a maneuver by turning the direction of the colon from the left to the right for this type. Pattern C is indicated by a redundant sigmoid colon or a postoperative colon. It is not easy to reach the SD-j by progressing the 25cm distance from the AV. The operator must master many maneuvers (hooking the fold, the right turn shortening technique, abdominal manipulations, etc.) to shorten the redundant sigmoid colon. The operator should master fundamental insertion techniques through repeated examinations. We explain details of the insertion technique with a UPD (Position Detecting Unit) system. |