ASGE Annual Postgraduate Course Endoscopy 2022: Breakthrough to Excellence | DDW 2022-Rex

Rex_Top Tips for a High Quality Colonoscopy

Pdf Summary

In this document, Dr. Douglas Rex provides five tips for achieving a high-quality colonoscopy. The first tip emphasizes the importance of safety, highlighting the need to avoid pushing against fixed resistance, to switch to water in difficult sigmoid areas, and to be cautious during retroflexion in order to stay in the lower rectum and avoid forced maneuvers. The second tip focuses on the importance of studying and recognizing subtleties in both conventional adenomas and serrated lesions. The third tip emphasizes the need to master the basics of detection, such as measuring adenoma detection rate (ADR) and serrated lesion detection rate (SSLDR), utilizing split or same day preparation, using high definition white light, and employing meticulous technique. The document also provides withdrawal technique basics, including looking behind all folds, checking the right colon twice, scoring the prep after clean-up, and adequately distending the colon. The fourth tip advises examining the right colon twice in almost every patient, returning to the cecum after the first examination, and performing the second examination in retro. The fifth and final tip focuses on mastering cold snare resection, providing guidance on the placement and retrieval of the snare, as well as the inspection of the site. In conclusion, following these five tips—strict attention to safety, knowledge of subtleties, mastering the basics of detection, examining the right colon twice, and mastering cold snare polypectomy—can help ensure a high-quality colonoscopy.

Keywords

colonoscopy

high-quality

safety

subtleties

detection

withdrawal technique

right colon

prep

distending the colon

cold snare resection