In the evaluation of the source of occult bleeding, it is mandatory that the small bowel be investigated. But, the small bowel is the area where endoscopic approach is most difficult. The endoscopic evaluation of the small intestine has rapidly evolved over the last 10 years and now includes many of the diagnostic and therapeutic capabilities of standard endoscopic procedures. Various techniques have been developed, including fiberoptic sonde enteroscopy, retrograde ileoscopy, intraoperative enteroscopy, "push" enteroscopy using a pediatric colonoscope, and video enterocopy. Therefore, the small bowel enteroscope has shown great promise in the evaluation of obscure or persistent gastrointestinal bleeding. We have experienced a case of bleeding from jejunal leiomyosarcoma, which diagnosed with small bowel enteroscopy. So we report the case with a brief review of literature.
Colonoscopes ; Hemorrhage* ; Intestine, Small ; Leiomyosarcoma*

Endocuff (Arc Medical Design) is a U.S. Food and Drug Administration-approved device that is attached like a cap to the distal tip of the colonoscope; it is used to improve adenoma detection rates during colonoscopy. The aim of this review was to summarize and evaluate the clinical and technical efficacy of Endocuff in improving adenoma detection rate. A comprehensive literature review was performed to identify studies describing this technique. In this review article, we have summarized case series and reports describing Endocuff use and results. The reported indications, results, limitations, and complications are discussed.
Adenoma* ; Colonoscopes ; Colonoscopy ; Colorectal Neoplasms

BACKGROUND/AIMS: To prevent the transmission of pathogens by endoscopes, following established reprocessing guidelines is critical. An ideal reprocessing step is simple, fast, and inexpensive. Here, we evaluated and compared the efficacy and safety of two disinfectants, a tertiary amine compound (TAC) and ortho-phthalaldehyde (OPA). METHODS: A total of 100 colonoscopes were randomly reprocessed using two same automated endoscope reprocessors, according to disinfectant. The exposure time was 10 minutes for 0.55% OPA (Cidex® OPA, Johnson & Johnson) and 5 minutes for 4% TAC (Sencron2®, Bab Gencel Pharma & Chemical Ind. Co.). Three culture samples were obtained from each colonoscope after reprocessing. RESULTS: A total of nine samples were positive among the 300 culture samples. The positive culture rate was not statistically different between the two groups (4% for OPA and 2% for TAC, P=0.501). There were no incidents related to safety during the study period. CONCLUSIONS: TAC was non-inferior in terms of reprocessing efficacy to OPA and was safe to use. Therefore, TAC seems to be a good alternative disinfectant with a relatively short exposure time and is also less expensive than OPA.
Colonoscopes* ; Disinfectants* ; Endoscopes* ; o-Phthalaldehyde*

BACKGROUND/AIMS: A number of studies have reported wide variability in the colonoscope insertion time among patients who had prior abdominal surgery. The aim of this study was to investigate the effect of abdominal surgery on colonoscope insertion time. METHODS: The subjects were 192 patients with prior abdominal surgery, among 3,600 patients who underwent a colonoscopy at Samsung Changwon Hospital from May 2008 to May 2010. We collected the following data: insertion time, age, gender, height, weight, BMI, waist circumference, method of abdominal surgery, and the degree of bowel cleanliness. Previous abdominal operations were divided into colectomy, non-colectomy abdominal surgery, pelvic surgery, and laparoscopic surgery groups. RESULTS: The average colonoscope insertion time in patients with prior abdominal surgery (7.73+/-5.95 min) was longer than that of the non-surgery group (6.4+/-3.88 min). Patients in the colectomy groups were older and had a shorter insertion time (5.11+/-3.32 min) than patients in the other groups. CONCLUSIONS: Insertion of a colonoscope in patients with previous abdominal surgery was more difficult than that in the control group, except the colectomy group.
Colectomy ; Colonoscopes ; Colonoscopy ; Humans ; Laparoscopy ; Waist Circumference

BACKGROUND/AIMS: Loop formation during colonoscopy can adversely effect on completion rates, speed of intubation and patient tolerance of the procedure. The ability to vary endoscope shaft flexibility may help insertion to the cecum. The aim was to compare a variable colonoscope with adjustable shaft stiffness to a conventional colonoscope (CC). METHODS: Consecutive patients attending for day case colonoscopy were randomized for examination with either the conventional colonoscope (Olympus CF200Z) or a variable stiffness (VS) colonoscope (CFQ240AL). The time to the cecum, inserted length of scope at cecum, need for abdominal compression, need for rotation of body position and pain scores of patient were analyzed. RESULTS: Of 158 cases, 69 were performed with the CC, and 89 with VS. There was no difference in intubation time between VS (mean 5.15+/-2.61 min) and CC (6.01+/-3.31 min) in experienced group. However, intubation time was quicker with VS than with CC (VS: 8.48+/-5.59, CC: 11.58+/-4.70, p=0.039) and number of loop formation was less with VS (mean 1.20) than with CC (mean 1.84) (p=0.043) in trainee group. There were no significant differences in inserted length of scope at cecum, need for abdominal compression, pain score or need for patient rotation between VS and CC in two groups. CONCLUSIONS: There was no significant difference in cecal intubation time between two groups in experienced group. However, in trainee group, the intubation time was quicker and the number of loop formation were lower in VS group than CC group.
Cecum ; Colonoscopes* ; Colonoscopy ; Endoscopes ; Humans ; Intubation ; Pliability

Diagnostic and therapeutic exploration with flexible colonofiberscope has heen developed since last 15 years. During that time some endoscopist has been developing pediatric colonoseopy aind getting good results with the advent of new pediatric colonoscope, PCF, aince 1981. I experienced 25 cases of pediatric colonoscopy at the department of surgery of the Ewha Womane University Hospital during last 10 montha(1984 1-1984 10). Clinical analysis of 25 cases of pediatric colonoscopy were made and with my experienee and review of literatures, technical succees and failure rate, time needed for peciatric colonoscopy and comparison of Colonoscopy and barium enema were presented.
Barium ; Colonoscopes ; Colonoscopy* ; Enema ; Female ; Humans

No abstract available.
Carbon Dioxide* ; Carbon* ; Colonoscopes* ; Insufflation* ; Water*

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) of large colorectal lesions is associated with increased procedural time. The objective of this study was to evaluate the effect of double-channel gastroscope (DCG) use on the procedural time of EMRs in the rectosigmoid area. METHODS: All EMRs for sessile or flat rectosigmoid lesions > or =2 cm performed between July 2011 and September 2012 were retrospectively analyzed. RESULTS: There were 55 lesions > or =2 cm in the rectosigmoid area in 55 patients, of which 26 were removed by EMR using a DCG (DC group) and 29 by using an ordinary colonoscope or gastroscope (OS group). The mean size of the removed polyps, morphology, adverse effects, and other parameters were similar between the two groups. The mean procedural time was significantly lower in the DC group than in the OS group (24.4+/-18.3 minutes vs. 36.3+/-24.4 minutes, p=0.015). Moreover, in a subgroup of patients with polyps >40 mm, the statistical difference in the mean procedural time between the DC and OS groups was even more pronounced (33+/-21 minutes vs. 58.7+/-20.6 minutes, p=0.004). CONCLUSIONS: Our data suggest that the use of a DCG in the resection of large nonpedunculated rectosigmoid lesions significantly reduces the procedural time.
Colon* ; Colonoscopes ; Colonoscopy ; Gastroscopes* ; Humans ; Polyps ; Retrospective Studies

A 39-year-old man presented with dizziness and melena for 2 months. Abdominal CT scan showed constrictive wall thickening with enhancement and proximal loop dilatation of the jejunum. On endoscopic examination, there was large amount of bile stained fluid in duodenum. Enteroscopy using pediatric colonoscope demonstrated an encircling mass with obstruction approximately 20 cm distal to the ligament of Treitz. Endoscopic jejunal biopsy showed moderately differentiated adenocarcinoma. Small intestinal adenocarcinoma is uncommonly encountered in clinical practice. Because small intestine is relatively inaccessible via routine endoscopy, diagnosis of small intestinal neoplasm is often delayed for several months after the onset of symptoms. Most of the patients are diagnosed in advanced stage. Therefore, when a small bowel neoplasm is suspected, enteroscopy is the most useful study. If enteroscope is not available, enteroscopy using pediatric colonoscope may permit earlier preoperative diagnosis. We report a case of primary jejunal adenocarcinoma diagnosed by endoscopic biopsy using pediatric colonoscope.
Adenocarcinoma/*pathology/radiography/surgery ; Adult ; Colonoscopes ; Endoscopy, Gastrointestinal ; Humans ; Jejunal Neoplasms/*pathology/radiography/surgery ; Male

PURPOSE: Colonoscopy is one of the most effective diagnostic and therapeutic tools for colorectal diseases. We aim to propose a master-slave robotic colonoscopy that is controllable in remote site using conventional colonoscopy. MATERIALS AND METHODS: The master and slave robot were developed to use conventional flexible colonoscopy. The robotic colonoscopic procedure was performed using a colonoscope training model by one expert endoscopist and two unexperienced engineers. To provide the haptic sensation, the insertion force and the rotating torque were measured and sent to the master robot. RESULTS: A slave robot was developed to hold the colonoscopy and its knob, and perform insertion, rotation, and two tilting motions of colonoscope. A master robot was designed to teach motions of the slave robot. These measured force and torque were scaled down by one tenth to provide the operator with some reflection force and torque at the haptic device. The haptic sensation and feedback system was successful and helpful to feel the constrained force or torque in colon. The insertion time using robotic system decreased with repeated procedures. CONCLUSION: This work proposed a robotic approach for colonoscopy using haptic feedback algorithm, and this robotic device would effectively perform colonoscopy with reduced burden and comparable safety for patients in remote site.
*Algorithms ; Colonoscopes ; Colonoscopy/instrumentation/*methods ; Equipment Design ; *Feedback ; Humans ; Robotics/*methods ; Torque