Water Immersion Colonoscopy Technique

Water Immersion Colonoscopy Technique

Index | Japanese | Chinese | Spanish | Previous | Next


4.

CONVENTIONAL INSERTION TECHNIQUE - PUSH METHOD AND PULL METHOD

WHERE IN SIGMOID COLON TO START SHORTENING

There are two insertion methods in the sigmoid colon: In Push method, as the name indicates, the scope is pushed until passing SD (sigmoid-descending colon junction), while in the Pull method the scope is pulled back at right over the S-top.

Push method; push the scope to SD and form a loop once. Then hook the scope and dissolve the loop.

Pull method; hook the scope at the S-top and shorten the colon so that the intestine is straightened when SD is reached.

 

WHERE IN TRANSVERSE COLON TO START SHORTENING

With the Push method, the scope is pushed until passing the hepatic flexure. During the Pull method, pulling starts at the center of the transverse colon.

Like in the sigmoid colon, a loop is dissolved after the tip of the scope is pushed to reach the hepatic flexure.

During the Pull method, pulling starts at the center of the transverse colon and the colon is straightened when the hepatic flexure is reached.

 

MOVIE 4-1

1
00: 00: 00,000 -> 00: 00: 03, 734
S pushing the latter half is called the push method.

2
00: 00: 03, 734 -> 00: 00: 07, 151
Now, press S first half.

3
00: 00: 07, 151 -> 00: 00: 13, 382
And here you can see the top of S and cross it, then press the latter half of S.

4
00: 00: 13, 382 -> 00: 00: 24,085
Then SD will be visible and it will be deducted when it crosses SD.

 

MOVIE 4-2

1
00: 00: 00 000 -> 00: 00: 02, 912
S pulling the latter half is the pull method.

2
00: 00: 02,912 -> 00: 00: 06,008
Go through the rectum and enter S.

3
00: 00: 06,008 -> 00: 00: 08, 943
S Press forward in the first half.

4
00: 00: 08,943 -> 00: 00: 13,568
S top will be visible and S top will be crossed.

5
00: 00: 13,568 -> 00: 00: 16, 645
Since it is S late after S over the top,

6
00: 00: 16,645 -> 00: 00: 19, 912
I will withdraw from here.

7
00: 00: 18, 911 -> 00: 00: 21, 861
I came and approached the SD,

8
00: 00: 21,861 -> 00: 00: 26,064
It passes SD without pushing as it is.

9
00: 00: 26,099 -> 00: 00: 30,536
It is about to pass SD now.

10
00: 00: 30,536 -> 00: 00: 34,512
Passing SD to the right is Descending.

11
00: 00: 34,512 -> 00: 00: 37,961
This is the pull method because I drew S second half.

 

MOVIE 4-3

1
00: 00: 00,000 -> 00: 00: 06,600
This video shows only where the scope tip is located

2
00: 00: 06,600 -> 00: 00: 07,816
It is the same as before.

3
00: 00: 07,816 -> 00: 00: 13, 410
Since it is a push method, it is after the top of S

4
00: 00: 13,410 -> 00: 00: 15,575
S The second half is also pushed.

5
00: 00: 15,575 -> 00: 00: 25, 130
Now, push and push to SD and after crossing SD

6
00: 00: 25,130 -> 00: 00: 30,570
I am pulling for the first time here and straightening it.

 

MOVIE 4-4

1
00: 00: 00 000 -> 00: 00: 0 6, 549
This is the same as the previous video

2
00: 00: 06, 549 -> 00: 00: 11, 430
It shows the scope end of the pull method.

3
00: 00: 11,430 -> 00: 00: 15,029
After crossing over S top,

4
00: 00: 15,029 -> 00: 00: 20,660
Please pay attention to where we are attracting the latter half.

5
00: 00: 20,660 -> 00: 00: 28, 854
I entered Descending while pulling SD past the right.

 

MOVIE 4-5

1
00: 00: 00,000 -> 00: 00: 04, 039
The push method first pushes with counterclockwise to advance the rectum.

2
00: 00: 04,039 -> 00: 00: 10,670
When entering the sigmoid colon, turn it to the right.

3
00: 00: 10,670 -> 00: 00: 13, 214
S top will cross over with up angle.

4
00: 00: 13,214 -> 00: 00: 17,702
Then press to SD to advance.

5
00: 00: 17,702 -> 00: 00: 25, 654
For normal hooks also push SD and cross over.

6
00: 00: 25,654 -> 00: 00: 29,534
As soon as it crosses over, it will shorten by pulling with the right hand turn.

 

MOVIE 4-6

1
00: 00: 00,000 -> 00: 00: 04, 167
Pull method also pushes with the counterclockwise turn to advance the rectum.

2
00: 00: 04, 167 -> 00: 00: 14, 607
When entering the sigmoid colon, turn it to the right.

3
00: 00: 14,607 -> 00: 00: 17,104
S top will cross over with up angle.

4
00: 00: 17, 104 -> 00: 00: 25, 255
I draw from here and get closer to SD.

5
00: 00: 25,255 -> 00: 00: 28,934
SD crosses with light rotation, right angle.

6
00: 00: 28,934 -> 00: 00: 40,605
Shortening has already been completed if it crosses over.