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COLLAPSE‐SUBMERGENCE METHOD: SIMPLE COLONOSCOPIC TECHNIQUE COMBINING WATER INFUSION WITH COMPLETE AIR REMOVAL FROM THE RECTOSIGMOID COLON
Author(s) -
Mizukami Takeshi,
Yokoyama Akira,
Imaeda Hiroyuki,
Kumai Koichiro
Publication year - 2007
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2007.00670.x
Subject(s) - medicine , descending colon , colonoscopy , sigmoid colon , rectum , lumen (anatomy) , surgery , suction , rectosigmoid colon , mechanical engineering , colorectal cancer , cancer , engineering
Colonoscopy is a difficult examination to conduct for inexperienced examiners. In an attempt to improve the view, there is often a tendency to overinsufflate air, which causes elongation or acute angulations of the colon and makes passage of the scope difficult. Sakai et al . were the first to describe a simple colonoscopic technique using water infusion instead of air insufflation. We have modified this technique to simplify the procedure further by combining water infusion using disposable syringes with complete air suction from the rectum to the descending colon. With the resultant elimination of the boundary lines between water and air, a good view of the lumen is obtained though the transparent water. With the patient in the left lateral position, this procedure allows the water to flow straight down into the descending colon through the ‘collapsed’ lumen, and the scope to be easily negotiated through the straightened recto‐sigmoid colon and sigmoid‐descending colon junction with minimum discomfort. Measurements of the patients’ abdominal circumference during colonoscopy showed that colonic distension hardly occurred. Under supervision by the author, six complete novices were allowed to insert the colonoscope within 10 min by this method for one patient per week, as long as the patients did not complain of pain. The average trial number for the first cecal intubation within 10 min was 3.3, and the average success rate during the first 3 months was 58.6%. We believe that this ‘collapse‐submergence method’ is easy to master, even for inexperienced examiners.