Formation of loops in the colon
A. Formation of loops in the colon can cause patient discomfort, difficulty in advancing the scope, and may increase the risk of perforation. B. Here an alpha loop has been formed in the sigmoid colon, facilitating passage into the descending colon. Clock
Patient position and room setup
Patient position and room setup. A video monitor is placed in the direct line of sight of the endoscopist (at the back of the patient) and the assistant (who stands in front of the patient). Monitoring equipment for EKG, blood pressure, and oxygen saturat
Intubation by dither-torquing
Intubation by dither-torquing. A. The shaft is torqued counterclockwise while advancing the shaft 10 to 15cm. B. The shaft is torqued clockwise while withdrawing the shaft 10 to 15 cm. Repetition of this cycle encourages the sigmoid to accordionize onto
Intubation by looping
Intubation by looping. A. The sigmoidoscope is advanced to the distal sigmoid. B. Counterclockwise torquing during further advancement loops the proximal sigmoid in front of the distal sigmoid. C. The looped sigmoid flattens the angle at the distal-descen
Intubation by elongation
Intubation by elongation. A. The sigmoidoscope is advanced to the proximal sigmoid. B. Severe tip deflection prevents further advancement resulting in sigmoid elongation. C. Clockwise torquing and shaft withdrawal accordionizes the sigmoid.