New insertion technique in colonoscopy, forming N-loop and using a stiffening cord

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Devices

Background:

• Colonoscopy is essential for colorectal cancer screening and diagnosis.
• Navigating the sigmoid colon can be challenging, often requiring fluoroscopy.
• Loop formation during colonoscopy can impede visualization and prolong the procedure.

Purpose of the Study:

• To introduce and evaluate a new, simplified colonoscopy insertion technique.
• To assess the efficacy of the technique in navigating difficult colonic segments.
• To determine the feasibility of achieving high cecal intubation rates without fluoroscopic guidance.

Main Methods:

• A novel insertion technique involving a middle-length colonoscope was developed.
• A small N-loop was formed in the sigmoid colon to facilitate passage.
• A differing cord was utilized to straighten the sigmoid and transverse colon segments.
• Fluoroscopy was not used during the procedure.

Main Results:

• The technique facilitated easy passage through the sigmoid colon.
• The differing cord effectively straightened colonic loops.
• The ileocecal area was observed in 86.7% of cases (26 out of 30).
• The average insertion time was 17.4 minutes.

Conclusions:

• This new colonoscopy technique simplifies insertion, particularly in the sigmoid colon.
• It enables effective visualization of the colonic mucosa and terminal ileum.
• The technique offers a fluoroscopy-free approach to colonoscopy with high cecal intubation rates.