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colonoscopy skills

- Sep 27, 2018 -

Due to the good coordination and the convenience of some special techniques, the single-person operation makes the inspection effect better. There are several techniques for different methods of entering the intestine segment:

1. Straight J-colon and B-colon colonic transition: Through continuous rotation of the mirror and straightening of the mirror body, the lower intestinal tube is placed on a 30cm mirror. The purpose of the mirror is to change the direction of the intestine to the upper or lower side of the field of view, and then adjust the upper and lower knobs (sometimes to adjust the left and right buttons) to expose the intestine into the mirror. Repeated pullback combined with panning mirror and shaking mirror can make the mirror body straight, and stack the long, free sigmoid colon on the mirror body, laying the foundation for the next step.

2, rotary into the mirror: When the intestinal lumen is in the field of view and there is no obvious steering, do not directly send the mirror forward, but use the rotary lens. The rotary mirror mentioned here is different from the mirror mentioned above. The method is to hold the mirror body with the right hand, and rotate the mirror body to the left and right along the longitudinal axis of the mirror body at the same time. The author summarizes the method of mirroring. Rotary mirror. The advantage is that the hand strength can be accurately transmitted to the front end of the endoscope, preventing the lens body from bowing in the body, thereby avoiding the abnormal pain caused by elongating the free intestine, preventing the formation of distortion; and reducing the power of the right hand into the mirror, and Complete the operation with ease. The principle is like acupuncture needle puncture the skin: the needle needs to be applied directly, and it is easy to bend the needle. If it is gently rotated, it is easy to keep straight. This method is simple and practical, and is especially suitable for use when descending the sigmoid colon.

3, colon spleen: such as excessive distortion of the spleen to make the spleen curvature an acute angle, only the buckling of the buckling can cover the entire intestinal lumen, at this time blind blind mirror can cause pain, intestinal wall damage, and even cause perforation. You can change the right lateral position into the mirror, or turn the crease to the lower side of the field of view through the mirror, send the front end of the endoscope to the crease, the left hand rotates the large knob downward, the mirror end presses the crease, and the hook pulls, Slightly retreat the mirror, make the spleen blunt, and expose the intestinal cavity into the mirror, while the left hand returns to the angle button. This method can also be used when the colonoscopy is difficult for hepatic flexion.

4, ascending colon: When the endoscope of the endoscope has just passed the hepatic curvature, it is often exposed to the intestine of the ascending colon, but it is difficult to enter the mirror, and even does not retreat. Because the hand strength can not be transmitted to the front end of the endoscope, the colonoscope is arched in the transverse colon. At this point, the mirror should be removed first, and the assistant should press the patient's umbilicus and push the top of the xiphoid rib to force the colon to sag, and then the mirror can be successful.



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