Description
Approaching a Difficult Colonoscopy - Scoping Summary
Risk factors for failed C-scope:
• Incr Age
• Female sex
• History of abdominal or pelvic surgery
• Private practice setting
Most common reason:
1) Redundant Colon
2) Difficult Sigmoid
Variable stiffness scopes (VSC):
• Higher cecal intubation rate
• Fewer position changes
• similar cecal intub. time, sedation time & manual pressure
Water assisted colonoscopy:
• Water exchange C-scope
• Water immersion in failed/redundant colons
• Incr cecal intubation rates
• Decr the need for external straightening devices and position changes
Prone positioning:
• Obese patients -> shorter cecal intubation times 420s vs 550s
Abdominal pressure:
• Successful C-scopes - 78% L. sided pressure, 47% R. sided pressure
Abdominal Binder:
• Reduced Cecal intubation time
• Less position changes, distension, pressure
• Abdominal Compression Device (ACD)
• ACD vs manual pressure -> reduction in cecal intubation time 6.38 min vs 11.8 min
By Dr. Hassaan Zia @HassaanZiaMD via ScopingSundays @ScopingSundays
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