A linear sigmoid colon passage method in colonoscopy

2 Satoshi Awazu, Risa Araki, Toshihiko Awazu 3 4 Awazu Hospital, Nagasaki, Japan 5 6 Address correspondence to Satoshi Awazu, Awazu Hospital, Nagasaki 851-0251, Japan. Phone: 7 +81-95-826-9088. E-mail: [email protected]. 8 9 10 ABSTRACT 11 12 A previous study revealed loop formation of the colonoscope in the sigmoid colon in 13 79% of patients. Colonoscope looping in the sigmoid colon is considered to cause 14 abdominal pain and intestinal perforation. We discovered a phenomenon whereby the 15 rectosigmoid junction becomes linear when the patient is moved from a left lateral to left 16 semiprone position and the colonoscope tip can be readily inserted into the sigmoid colon. 17 Therefore, this phenomenon was applied to our conventional insertion method to determine 18 whether the colonoscope looping rate in the sigmoid colon can be reduced. Thus our new 19 insertion method could reduce the colonoscope looping rate in the sigmoid colon. Our new 20 insertion method may allow safer colonoscope insertion than our conventional insertion 21 method. 22 23 24 INTRODUCTION 25 26 A previous study revealed loop formation of the colonoscope in the sigmoid colon in 27 79% of patients (Shah et al., 2000). Colonoscope looping in the sigmoid colon is 28 considered to cause abdominal pain and intestinal perforation (Lüning et al., 2007). 29 We previously reported that the colonoscope can be readily inserted through the 30 sigmoid-descending colon junction in a left semiprone position (Awazu, Araki & Awazu, 31 2012). Therefore, we considered that the colonoscope can be readily inserted through the 32 rectosigmoid junction in a left semiprone position. 33 In fact, we discovered a phenomenon (Fig. 1) whereby the rectosigmoid junction 34 becomes linear when the patient is moved from a left lateral to left semiprone position and 35 the colonoscope tip can be readily inserted into the sigmoid colon by pushing. Therefore, 36 this phenomenon was applied to our conventional insertion method to determine whether 37 the colonoscope looping rate in the sigmoid colon can be reduced. 38 39 40 41 42 43 44