COLONOSCOPY PROCEDURE | PATIENT PREPARATION | HISTORY
- In 1971 colonoscopy was first describe, significant technical advancement have been made in terms of instrument handling and imaging capability. Yet, colonoscopy remains a procedure requiring manual skills and focus. 98% of the cecum can be now successfully reach by the experienced examiner. Elongated sigmoid colon or transverse colon together with postoperative intestinal fixations and other adhesions. 30mins are required for the entire examination. Quick advancement and analysis up to the cecum is advantage, all in all the discomfort to the patient, though a careful examination of all colon segments when extracting the instrument is important for a thorough examination.
- Proper practice and experience are necessary for correct diagnosis. Colonoscopy has diagnostic spectrum that encompasses not only macroscopic assessment of the condition of the mucosa, but also the possibility of collecting a targeted biopsy sample and, more recently, the use of dye spraying techniques and magnification. The flexible instrument channel of endoscope in endoscopy allows for therapeutic treatment during the procedure to some degree not possible with any other imaging technique. Polyps, for example, can be removed at first diagnosis and bleeding can be stopped immediately. Thus, colonoscopy is a technically demanding examination procedure with a high clinical yield combined with the capability of therapeutic intervention.
- Colonic Mucosa condition is important to be assessed where there are clinical indication of colitis, like abdominal pain, malabsoption, diarrhea, perianal bleeding as a result of possible imflammation, erosions, intestinal ischemia ulcers of various genese, polyps and tumors, diverticula or vascular malformations.Changes in bowel habits and tendency of constipation are the cause for performing and endoscopic search for a stricture in the intestinal canal, like due to neoplasm, diverticular myochosis or postinflammation stricture.
- Thickening of the intestinal wall can be viewed using and imaging techniques such as ultrasound, magnetic resonance imaging and ct scan. A resulting pathological diagnosis is an indication for colonoscopy that usually can provide most accuracy and allows taking a biopsy.
COLONOSCOPY PREP ARATION ON PATIENTS
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| Colonoscopy, Left lateral Position |
- Before doing colonoscopy, abdomen examination the patient should be in supine position. In addition to general clinical examination procedure surgical scars and hernias like in umbilical or incisiona hernias and inguinal must give special attentions. At the beginning of the actual colonoscopy the patient should be in lateral position, knees bent and pulled up. In this position perianal inspection is attainable, as is palpation and the insertion of the endoscope tip into the anus. Ileocolonoscopy can often be achieved in the left lateral position easily. Position may alter during the rest of the colonoscopy. Majority of the patiets, changing of position after the procedure going the rest of the procedure makes easier.
- Supine position has the advantage of enabling external compression and splinting especially for the sigmoid and transverse colon, and localization of the endoscope makes easier.
For trouble spots like coursing the rectosigmoid junction or the hepatc flexure, as well as intubation of the ileocecal valve, repositioning the patient from the lateral to supine or even the right lateral position can also be helpful.
- Withdrawing the endoscope after reaching the terminal iluem the patient position is depends on the examiner's preference, but most of the time are done in supine position.
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