Use of a Variable-Stiffness Colonoscope Allows Completion of Colonoscopy after Failure with the Standard Adult Colonoscope

 

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Background and Study Aims: Experts fail to reach the cecum in 2 - 10 % of colonoscopies. The purpose of this case series was to evaluate the efficacy of a small-caliber, variable-stiffness colonoscope in patients with incomplete colonoscopy.
Patients and Methods: The variable-stiffness colonoscope (Olympus America XPCF-140AL) was used by the same examiner to reattempt colonoscopy immediately in all patients in whom colonoscopy to the cecum with the standard colonoscope was incomplete.
Results: Sixteen of 385 attempted colonoscopies (4.2 %) did not reach the cecum with the standard colonoscope due to looping (n = 12), fixed angulation of the sigmoid colon (n = 3), and diverticulosis (n = 1). The procedures were deemed a failure after a mean of 28 min, despite the use of abdominal pressure and positional change in all patients. Fifteen of the 16 patients (94 %) had a complete colonoscopy with the variable-stiffness colonoscope. One patient had an incomplete colonoscopy with the variable-stiffness colonoscope due to an obstructing mass in the transverse colon that was not reached by the standard colonoscope. With the variable-stiffness colonoscope, the mean time to cecal intubation was 10.3min; four patients (25 %) required a change in patient position, and six patients (37.5 %) required abdominal pressure.
Conclusions: A variable-stiffness colonoscope allowed completion of colonoscopy in all patients without obstruction who had an incomplete colonoscopy with the standard colonoscope. Further study is needed to determine whether the variable-stiffness colonoscope should be used routinely for colonoscopy.

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R. M. Katon, M.D.

Division of Gastroenterology, PV-310 · Oregon Health Sciences University ·

3181 SW Sam Jackson Park Road · Portland, OR 97201-3098 · USA ·

Fax: + 1-503-494-7556

Email: katonr@ohsu.edu