| Theme |
Management for the risk of colonoscopy |
| Title |
Education on risks of colonoscopic insertion |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Kazuo Ohtsuka |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Fuyuhiko Yamamura |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Keita Sasajima |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yoshio Omae |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Makoto Kaga |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Jun-ichi Ukegawa |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Yasutoshi Kobayashi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Ryo Chinzei |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
The insertion of colonoscopes is the basis for the diagnosis and treatment of colorectal lesions. Compared with other endoscopic examinations, colonoscopy is associated with higher risks of complications during the insertion of the scope. Education on risks related to colonoscopic insertion should start at the beginning of training for colonoscopy. We always supervise the beginner's examinations, and as a rule, a senior doctor will take over the examination when it has taken more than 15 minutes for the insertion, or if the patient has begun to complain of pain. We teach our “straight and shortening” methods for colonoscopic insertion. The basic rule of the methods is to try not to push the scope, not to form a loop, not to insufflate a great deal of air, and to telescope the colon as much as possible. This method is safe, is accompanied with less pain, and makes observation and treatment of colorectal lesions easier. Excessive dependence on sedatives is dangerous because the medication itself may cause substantial adverse effects, and because we may not realize that the patient is at risk of perforation if they are deeply sedated and cannot vocalize. Step by step training moving from the colon model or simulator, to real but easy cases, and then to more difficult cases, is the best way to learn insertion techniques. |