By Douglas Adler MD
Core options in Colonoscopy covers all facets of diagnostic and healing colonoscopy, emphasizing overarching innovations that gastroenterology fellows and physicians needs to recognize to be successful in either the technical and cognitive elements of the process. during this complete source, Dr. Douglas G. Adler and his individuals presents a simple and sensible evaluation of colonoscopy.
Core recommendations in Colonoscopy aims to deal with and bring the middle strategies of colonoscopy: from the constitution and serve as of the colonoscope itself, to insertion strategies, loop formation and aid, polypectomy innovations for any state of affairs, the avoidance and administration of perforations and different adversarial occasions, in addition to complex ideas together with (but no longer constrained to) endoscopic mucosal resection and colonic stenting.
Each bankruptcy within Core strategies in Colonoscopy is lavishly illustrated with a number of key photographs to intensify and improve the written textual content, in addition to a plethora of tips, methods, and amassed issues of knowledge in every one bankruptcy on all features of colonoscopy.
Additional web site Component!
Core strategies in Colonoscopy is followed by means of a video web site with particular video clips hooked up to person chapters that would illustrate simple and complex colonoscopic options from many major specialists and should extra increase the educational technique. The addition of the video site makes it possible for an improved studying adventure and permits the reader to observe, hear, view many times, and reinforces the innovations awarded within the written text.
GI fellows, junior gastroenterologists, or even complicated physicians will enjoy Core techniques in Colonoscopy due to the trouble-free and effective constitution that enables for the fabric to be quick learn, in addition to simply take up the wealth of key useful wisdom came upon inside.
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Extra info for Core Concepts in Colonoscopy
The left hand is used to hold the colonoscope control head and the right hand holds the shaft of the endoscope 10 to 20 cm from the anus so that force is transmitted straight up through the endoscope in an attempt to minimize looping. As a general rule, during insertion of the colonoscope, one should insufflate as little air as possible—just enough to see the lumen. As more air is insufflated, the bowel distends and lengthens. This increases patient discomfort and makes it more difficult to advance the colonoscope than it would be in a decompressed colon.
The sigmoid colon is not fixed within the abdomen, and as such can be moved by the effects of the endoscope, air insufflation, or both. As such, minimal air should be insufflated into the sigmoid colon to reduce the risk of forming a loop in the first place. Difficulties in advancing the endoscope through the sigmoid colon are commonly caused by inexperience, diverticulosis, or previous abdominal/pelvic surgery. If a loop develops in the sigmoid colon and reducing the loop does not allow the endoscope to advance, applying abdominal pressure to the suprapubic area is usually enough to assist one in moving the endoscope through the sigmoid colon.
As more air is insufflated, the bowel distends and lengthens. This increases patient discomfort and makes it more difficult to advance the colonoscope than it would be in a decompressed colon. It is important to keep the colonoscope as straight as possible during the entire procedure to prevent excess looping. The endoscope is straightened by withdrawal (pulling back), especially after negotiating a turn. When significant looping occurs, such that the colonoscope will not advance or seems to withdraw when the shaft is advanced into the colon, external compression is needed.