Supine Colonoscopy: An Advantage over Left Lateral in Synchronous Proctological Surgery

Repositioning sedated or anesthetized patients between colonoscopy and further surgical procedures is potentially unsafe and time consuming. We aim to show that colonoscopy performed in the modified lithotomy position offers surgical, anesthetic, and patient advantage.

Patients presenting for colonoscopy and a synchronous surgical procedure between May 2013 and August 2014 were prospectively included. Colonoscopy duration, cecal intubation rate (CIR), terminal ileum intubation rate, and patient characteristics were recorded.

Sixty-eight patients were included in this study. Of them, 24 (35%) were women and mean age was 42.3 years. Mean colonoscopy duration was 7 minutes (2-24 minutes). CIR was 100%. Terminal ileum intubation rate was 92%. Utilization of ancillary colonoscopic maneuvers was easier for the operator/assistant. Overall theatre time was reduced and there was no increase in length of stay.

The modified lithotomy position offers multiple surgical, anesthetic, theatre, and patient advantage in those undergoing a colonoscopy followed by a further proctological or surgical procedure.