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Archive December 2017 XVIII, No. 12

Tools for Difficult Colonoscopies

Help your doctors see more clearly and move more easily through the colon with the latest scopes and add-ons.

Anna Merriman

Anna Merriman, Associate Editor


colonoscopy screening A BETTER LOOK Let your GI docs increase their visualization and improve their maneuverability during colonoscopy screenings.

The quality of your colonoscopy screenings is tied directly to your GI doctors' ability to easily move through the colon to the end and to visualize everything — including hidden polyps behind the colonic folds — along the way. You can keep your ADR (adenoma detection rate) and cecal intubation rates high by investing in the latest flexible endoscopes and innovative scope attachments to help with maneuverability and visibility so that your GI doctors can move more easily through the colon and see more clearly. Here's a review.

Moving the scope successfully and safely can be a tricky thing. That's where certain types of scope tools, like 3D imaging technology, can be an enormous help. Some scopes have the imaging technology built into the body of the scope. The technology lets your doctors see a 3D image of the scope on a nearby screen, including every little motion and loop the device makes, says Seth Gross, MD, chief of gastroenterology at Tisch Hospital in New York, N.Y.

This can help doctors identify which type of loop is giving them trouble, whether it's an 'N' loop, which is seen in 80% of colonoscopies; a deep transverse loop, which is seen in about 30% of cases; an alpha loop, which is seen in 10% of cases; or one of the less common loops, says gastroenterologist Doug Weine, MD, of Red Bank (N.J.) Gastroenterology. Being able to visualize the specific loops helps doctors know when to torque the scope and which moves to use to pull the loop out of its position.

While many more experienced GI docs are trained to notice an error in the scope's movements without the use of 3D imaging, it can be a boon to newer physicians and physicians in training, says Dr. Weine. That's especially true when, during a colonoscopy, doctors reach the splenic flexure, where they can find some resistance as the scope works its way into the transverse colon, he says. In that case, some less-experienced doctors will just try to push the scope forward without the appropriate amount of delicacy. "You can actually rupture the spleen," says Dr. Weine.

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