Use of a variable-stiffness colonoscope allows completion of colonoscopy after failure with the standard adult colonoscope

D. A. Shumaker, A. Zaman, R. M. Katon

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Abstract

Background and study aims: Experts fail to reach the cecum in 2-10% of colonoscopies. The purpose of this case series was to evaluate the efficacy of a small-caliber, variable-stiffness colonoscope in patients with incomplete colonoscopy. Patients and methods: The variable-stiffness colonoscope (Olympus America XPCF-140AL) was used by the same examiner to reattempt colonoscopy immediately in all patients in whom colonoscopy to the cecum with the standard colonoscope was incomplete. Results: Sixteen of 385 attempted colonoscopies (4.2%) did not reach the cecum with the standard colonoscope due to looping (n = 12), fixed angulation of the sigmoid colon (n = 3), and diverticulosis (n = 1). The procedures were deemed a failure after a mean of 28 min, despite the use of abdominal pressure and positional change in all patients. Fifteen of the 16 patients (94%) had a complete colonoscopy with the variable-stiffness colonoscope. One patient had an incomplete colonoscopy with the variable-stiffness colonoscope due to an obstructing mass in the transverse colon that was not reached by the standard colonoscope. With the variable-stiffness colonoscope, the mean time to cecal intubation was 10.3 min; four patients (25%) required a change in patient position, and six patients (37.5%) required abdominal pressure. Conclusions: A variable-stiffness colonoscope allowed completion of colonoscopy in all patients without obstruction who had an incomplete colonoscopy with the standard colonoscope. Further study is needed to determine whether the variable-stiffness colonoscope should be used routinely for colonoscopy.

Original languageEnglish (US)
Pages (from-to)711-714
Number of pages4
JournalEndoscopy
Volume34
Issue number9
DOIs
StatePublished - Sep 12 2002

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ASJC Scopus subject areas

  • Gastroenterology

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