ASGE Annual Postgraduate Course Endoscopy 2022 (On-Demand): Breakthrough to Excellence-Rex

Rex_Top Tips for a High Quality Colonoscopy

Pdf Summary

In this document, Dr. Douglas K Rex provides five tips for a high-quality colonoscopy. <br /><br />Tip #1 emphasizes the importance of safety during the procedure. This includes avoiding pushing against fixed resistance, using water instead of air in difficult sigmoid cases, being cautious during retroflexion (staying in the lower rectum and not forcing the maneuver), and considering the position of the spleen. <br /><br />Tip #2 highlights the need to understand the subtleties of both conventional adenomas and serrated lesions, as these are types of precancerous lesions that can be encountered during a colonoscopy. <br /><br />Tip #3 focuses on mastering the basics of detection, such as measuring adenoma detection rate (ADR) and serrated lesion detection rate (SSLDR) in your institution, using high-definition white light, practicing meticulous technique, and allowing a sufficient withdrawal time. <br /><br />Tip #4 advises examining the right colon twice in almost all cases, including both a forward examination and a retro examination. <br /><br />Tip #5 encourages mastering cold snare resection, a technique used to remove polyps during the colonoscopy. This includes following the Cold Snare Polypectomy Assessment Tool (CSPAT), which involves placing the snare accurately, keeping a good working distance, retrieving the specimen, and inspecting the site. <br /><br />Overall, these tips emphasize the importance of safety, knowledge, technique, and thorough examination in ensuring a high-quality colonoscopy.

Keywords

high-quality colonoscopy

safety during procedure

water instead of air

retroflexion caution

conventional adenomas

serrated lesions

detection basics

adenoma detection rate

withdrawal time

cold snare resection