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Updated: Jan 25, 2026

Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Changing from two- to one-operator colonoscopy insertion technique is feasible with similar quality outcomes
Hsu-Heng Yen1,2,3, Yu-Chun Hsu1
1Endoscopy Center Changhua Christian Hospital Changhua City Taiwan.
Background And Aim:
Colonoscopy can be performed with two-operator (2OP) or one-operator (1OP) methods. This study aimed to investigate the feasibility and colonoscopy quality outcomes for the two different colonoscopy insertion techniques.
Methods:
One colonoscopist from Changhua Christian Hospital learned and changed the colonoscopy insertion technique from 2OP to 1OP during 2013. Real-life results of screening colonoscopies performed by this colonoscopist between these two insertion techniques (year 2012: 2OP vs year 2014: 1OP) were retrospectively reviewed and compared.
Results:
In total, 219 screening colonoscopies were reviewed (2OP group, n = 103 vs 1OP group, n = 116). No differences were noted between both groups in terms of patient age, gender, weight, and height. The overall cecum intubation was 98.2%, adenoma detection rate (ADR) was 29.7%, and colonoscopy withdrawal time was 518.58 ± 972.04 s. On comparing colonoscopy quality outcomes between both methods, no differences were observed in cecal intubation rates (2OP vs 1OP: 100 vs 96.6%, P = 0.1626), ADR (28 vs 31%, P = 0.7401), and colonoscopy withdrawal time (454.88 ± 178.21 vs 576.92 ± 1325.01 s, P = 0.355). However, the 1OP group demonstrated significantly shorter colonoscopy insertion time (2OP vs 1OP: 298.28 ± 202.95 vs 216.21 ± 121.99 s, P = 0.003).
Conclusion:
Colonoscopy quality outcomes were not impaired when one endoscopist changed the colonoscopy practice pattern from 2OP to 1OP. However, 1OP significantly shortened the colonoscopy insertion time.
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