Colonoscopy was employed to attempt detorsion of volvulus of the right colon in four patients considered to be high-risk surgical patients. In one patient detorsion was accomplished, so that emergency laparotomy became unneccesary. The site of torsion was reached in every patient. When detorsion does not occur reasonably soon after the colonoscope enters the right colon, persistent efforts are more likely to be harmful than helpful. Abdominal symptoms in a patient who has been ill or injured for some time should suggest the possibility of volvulus of the right colon. Early diagnosis and earlier employment of colonoscopy would almost surely result in an increased rate of success in accomplishing detorsion. When detorsion is accomplished, subsequent resection of the right colon should be seriously considered as, without it, volvulus is said to recur frequently.

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An alternative to transcolonic polypectomy, transabdominally directed, transanal colonoscopic polypectomy, for patients who require polyp removal but in whose cases standard colonoscopic approach has failed is presented. The early results are excellent, and the method also can be applied to other patients who have colonic polyps who undergo procedures such as hysterectomy and cholecystectomy.