INTESTINE Vol.7 No.5(4-1)

特集名 Total colonoscopy -- 挿入理論とその応用
題名 挿入困難例とその克服方法 (1) S状結腸の通過 b. 焦らず,あくまで基本に忠実に
発刊年月 2003年 09月
著者 町田 マキヨ 田坂記念クリニック
著者 佐竹 儀治 田坂記念クリニック
【 要旨 】 要旨はありません。
Theme Theory of insertion technique in total colonoscopy and its practical application
Title Point on insertion technique in difficult sigmoid colon cases -- minimal air induction and detecting the next lumen at the twisted corner is important
Author Makiyo Machida Tasaka Memorial Clinic
Author Yoshiharu Satake Tasaka Memorial Clinic
[ Summary ] Total colonoscopy is sometimes difficult, even in cases with comparatively easy sigmoid colons. When we hurry, in order to pass through the sigmoid colon, we are liable to use too much air induction and cause the sigmoid colon to expand. It is always important for us to pass through the sigmoid colon steadily and carefully.
In the case of a truely elongated sigmoid colon or an adhered sigmoid colon, due to repeated gynecological operations, total colonoscopy may be very difficult. However, the method for excellent insertion in these difficult cases is not different from that of normal cases. Reduced air induction may cause the sigmoid colon to collapse and makes it easy to pass through with the least amount of pain.
The most important technique is one which will let us detect the next lumen without expansion of the sigmoid colon. We can detect next lumen and pass through the sigmoid colon easily by moving the scope to the right or to the left slowly and slightly touching the tip of the scope to the colonic mucosa at the twisted corner of the colon. We used the transparent hood on the tip of the scope. The transparent hood makes it easy to detect the next lumen, because we can maintain a reduced distance between the tip of the scope and the colonic mucosa.