A linear sigmoid colon passage method by left twisting

2 Satoshi Awazu, Risa Araki, Toshihiko Awazu 3 4 Awazu Hospital, Nagasaki, Japan 5 6 Address correspondence to Satoshi Awazu, Awazu Hospital, Nagasaki 851-0251, Japan. Phone: 7 +81-95-826-9088. E-mail: [email protected]. 8 9 10 ABSTRACT 11 12 We previously reported that the sigmoid-descending colon junction becomes linear and 13 the colonoscope can be readily inserted into the descending colon in the left semiprone 14 position. In addition, we encountered a situation whereby the sigmoid colon becomes more 15 linear and the colonoscope can be more straightly inserted in the sigmoid colon when the 16 colonoscope is inserted with twisting to the left in the left semiprone position. Therefore, 17 our new insertion method was devised so that the colonoscope neutral position was rotated 18 45 degrees to the left compared to our conventional insertion method, and this method was 19 performed to determine whether the colonoscope looping rate in the sigmoid colon can be 20 reduced. The colonoscope looping rate in the sigmoid colon could be reduced by using our 21 new insertion method. These results suggest that safer colonoscope insertion is possible by 22 using our new insertion method compared with our conventional insertion method. 23 24 25 INTRODUCTION 26 27 Colonoscope looping in the sigmoid colon is considered to cause intestinal perforation 28 (Lüning et al., 2007; Magdeburg et al., 2008; Shah et al., 2000). 29 We previously reported that the sigmoid-descending colon junction becomes linear and 30 the colonoscope can be readily inserted into the descending colon in the left semiprone 31 position (Awazu, Araki & Awazu, 2012). Therefore, we considered that the sigmoid colon 32 also becomes linear and the colonoscope can be readily inserted in the sigmoid colon in the 33 left semiprone position. 34 In addition, we encountered a situation whereby the sigmoid colon becomes more linear 35 and the colonoscope can be more straightly inserted in the sigmoid colon when the 36 colonoscope is inserted with twisting to the left in the left semiprone position (Fig. 1). 37 Therefore, we considered that the colonoscope can be more readily inserted in the sigmoid 38 colon when the colonoscope is inserted with twisting to the left in the left semiprone 39 position. 40