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Updated: Jun 18, 2026
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Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Endoscopist experience as a risk factor for colonoscopic complications
V Lorenzo-Zúñiga1, V Moreno de Vega, E Doménech
1Endoscopy Unit, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. vlorenzo.germanstrias@gencat.cat
Summary
Lower volume endoscopists performing colonoscopy had higher rates of colonic perforation and postpolypectomy bleeding. Endoscopist experience is a significant factor in colonoscopy safety.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Patient Safety
Background:
- Colonoscopy is a vital diagnostic and therapeutic tool.
- Complications such as colonic perforation (CP) and postpolypectomy bleeding (PPB) can occur.
- Endoscopist experience is a potential factor influencing complication rates.
Purpose of the Study:
- To determine the incidence of CP and PPB after colonoscopy.
- To assess the impact of endoscopist experience on these complication rates.
- To identify risk factors for adverse events during colonoscopy.
Main Methods:
- Retrospective review of 25,214 colonoscopies performed between 1995 and 2008.
- Data collection included demographic information, procedure details, and complication occurrences.
- Analysis focused on comparing complication rates based on endoscopist annual procedure volume.
Main Results:
- The overall incidence of CP was 0.51/1000 procedures, and PPB was 14.7/1000 procedures.
- The relative risk of complications was higher for endoscopists performing fewer than 591 procedures annually (4.0/1000) compared to higher-volume endoscopists (2.9/1000).
- This difference was statistically significant (P < 0.001).
Conclusions:
- The complication rates observed are comparable to previously reported data.
- Lower endoscopist volume is independently associated with an increased risk of bleeding and perforation following colonoscopy.
- Endoscopist experience is a critical factor in ensuring colonoscopy safety.
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