Anatomic Basis of Colonoscopy

• Critical knowledge of colorectal anatomy is imperative to performing appropriate endoscopic examinations. • Appreciation for anatomic variations can help in progress during colonoscopy. • Mural findings and internal clues are appropriate adjuvants in helping the endoscopist proceed with forward advancement and eventual cecal intubation. • Looping during colonoscopy is common. Various types of loops can be encountered, and appreciation of these formations is mandatory. Having a standardized protocol for preventing and reducing these loops is fundamental in assurance of forward progression and intubation while minimizing patient discomfort and morbidity. • Observation and verification of certain anatomic landmarks throughout the colon are helpful for providing a roadmap to continued intubation. Similarly, photography of some of these landmarks is required to document successful complete colonoscopy.