| [ Summary ] |
In total colonoscopy, it is usually not difficult to pass the transverse colon. However, in some cases with a history of abdominal operations, long colons, carcinoma, inflammatory disease or obesity, it is difficult to pass the transverse colon with the usual technique. In such difficult case, hand pressure and posture conversion methods are important to control the fiberscope. This is especially true, in patients with transverse colon adhesions, where it is necessary to press on the adhesion site, use of a right semi position is useful. In addition, hand pressure is more effective in both directions in the elongated region. Posture conversion, to the prone position, is also effective for obese patients. Patients, who had very long colons, were usually elderly aged and felt less pain. Therefore, gentle insertion techniques resolved difficulties in such long colon patients. In some patients with colon obstructions and severe stenosis from carcinomas or inflammatory bowel disease, using a thin fiber scope or other diagnostic methods is recommended. In conclusion, the usual insertion techniques, which include shortening and holding methods, plus hand pressure and posture conversion are important for difficult cases. |