Ancillary colonoscope insertion techniques. An evaluation

Colonoscope insertion from anus to cecum requires a sound basic technique that minimizes looping and maintains a straight scope. Four adjunct techniques may help advance insertion but none has been carefully evaluated. Accordingly, data were collected prospectively from 417 patients undergoing colonoscopy by the author. There were 223 males and 194 females with a median age of 60 years (range 12-94 years). Colonoscopy was complete in 405 cases (97.1%). The incidence and effectiveness of the four maneuvers were: hold breath (63%, 32%), abdominal pressure (65%, 60%), turn on left side (36%, 42%), turn on right side (19%, 77%). All 4 techniques were used in 54 patients (13%); 3 were used in 98 (24%); 2 in 98 (24%); 1 in 53 (13%); and none in 114 (27%). These ancillary techniques were more often used in females than males (P = 0.01); in intact colons more often than those after left colectomy (P = 0.001); and in patients of slim build than those of normal build (P = 0.04). Of the four techniques, abdominal pressure was most often used and turning on the right side was most often effective.