A study of optimal length of flexible fiberoptic sigmoidoscopes for initial endoscopic training

Abstract

Eighteen trainees with no prior fiberoptic endoscopic experience performed a total of 305 fiberoptic sigmoidoscopies using a colonoscope. Basic training, consisting of reading materials, lecture instructions, practice on a colon model, and observation of procedures, was completed prior to beginning patient examinations. Additional instruction was given between examinations. The performance of these examinations was an individual effort on the part of the trainee without verbal or mechanical assistance from the instructor after the initial ten examinations. All were performed with an instructor viewing through a teaching attachment. Total insertion distance was greater than or equal to 30, greater than or equal to 40, greater than or equal to 50, greater than or equal to 60 cm in 65, 60, 46, and 20 percent of examinations, respectively. Overall performance was better in those with prior rigid sigmoidoscopic experience (20 examinations). The mean examination time was 11.8 minutes. These data help to define the appropriate length of fiberoptic sigmoidoscope recommended for use by inexperienced endoscopists.

Adenomas and hyperplastic polyps in screening studies

“…Few adenomas were detected in the right side of the colon, but 8 patients had screen-detected cancer. Flexible sigmoidoscopy plus double-contrast barium enema (DCBE) instead of full colonoscopy would miss some of the neoplasms in the right side and probably also in the descending colon, which may not be reached in more than 20% of the persons having flexible sigmoidoscopy [16]. Rigid proctoscopy plus DCBE would be even less sensitive because of the low accuracy for neop!asia by DCBE in the sigmoid colon [17].…”

Procrastination and prognosis - medico-legal aspects of the diagnosis and timely treatment of colorectal cancer

“…16 The results of the Painter study were similar to those of Lehman et al who used endoscopically placed clips before barium enema to identify the proximal depth of insertion at FS. 8,17 They found that the sigmoidoscope had not passed into the descending colon in 48% of patients. Jensen et al used plain abdominal X ray to determine depth of insertion of the 60 cm flexible sigmoidoscope and found that they failed to enter the descending colon in 34% of patients.…”