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• W1971766525 abstract "BackgroundThe water immersion technique was first described in the US in the 1970s as a technique to assist in identifying the lumen during endoscopy cases with severe diverticular disease. Soon thereafter, Japanese endoscopists further pioneered the use of water-assisted insertion method during the entire procedure. More recently, several randomized control studies have investigated the role of water immersion method with minimum sedation colonoscopies. These studies showed that the water method, when compared to standard air insufflation, led to increased success rate of cecal intubation, faster time to the cecum and decreased patient discomfort during procedures with minimal or no conscious sedation. This video illustrates the endoscopic technique commonly used during water immersion colonoscopy.Endoscopic methodsWith standard air insufflation, the sigmoid colon is distended and rises with air, often leading to loop formation. By replacing air with water, the colon is weighed down and tends to assume a relatively straight configuration, which facilitates insertion. A continuous infusion of room-temperature water is achieved using the waterjet function of the colonoscope, while advancing the scope. Air pockets and fecal residue are simultaneously suctioned until only water remains in the lumen. Visualization of anatomic landmarks and gross findings, such as the appendiceal orifice, polyps, and diverticula are not compromised with this method. There are multiple variations to this method, including water temperature, volume of water injected upfront prior to advancing the scope, patient positioning, and partial underwater immersion.Clinical implicationsColonoscopies performed with the standard technique of air insufflation is considered a painful procedure. The use of conscious sedation, while often used, has risks of complications. Thus, the water immersion technique is a safe alternative in achieving higher success rates of endoscopy with minimal sedation. This is especially applicable in patients with high sedation requirements, or in patients with tenuous cardiopulmonary status. Further studies with a larger patient population are warranted to further validate the role and efficacy of the water immersion method. BackgroundThe water immersion technique was first described in the US in the 1970s as a technique to assist in identifying the lumen during endoscopy cases with severe diverticular disease. Soon thereafter, Japanese endoscopists further pioneered the use of water-assisted insertion method during the entire procedure. More recently, several randomized control studies have investigated the role of water immersion method with minimum sedation colonoscopies. These studies showed that the water method, when compared to standard air insufflation, led to increased success rate of cecal intubation, faster time to the cecum and decreased patient discomfort during procedures with minimal or no conscious sedation. This video illustrates the endoscopic technique commonly used during water immersion colonoscopy. The water immersion technique was first described in the US in the 1970s as a technique to assist in identifying the lumen during endoscopy cases with severe diverticular disease. Soon thereafter, Japanese endoscopists further pioneered the use of water-assisted insertion method during the entire procedure. More recently, several randomized control studies have investigated the role of water immersion method with minimum sedation colonoscopies. These studies showed that the water method, when compared to standard air insufflation, led to increased success rate of cecal intubation, faster time to the cecum and decreased patient discomfort during procedures with minimal or no conscious sedation. This video illustrates the endoscopic technique commonly used during water immersion colonoscopy. Endoscopic methodsWith standard air insufflation, the sigmoid colon is distended and rises with air, often leading to loop formation. By replacing air with water, the colon is weighed down and tends to assume a relatively straight configuration, which facilitates insertion. A continuous infusion of room-temperature water is achieved using the waterjet function of the colonoscope, while advancing the scope. Air pockets and fecal residue are simultaneously suctioned until only water remains in the lumen. Visualization of anatomic landmarks and gross findings, such as the appendiceal orifice, polyps, and diverticula are not compromised with this method. There are multiple variations to this method, including water temperature, volume of water injected upfront prior to advancing the scope, patient positioning, and partial underwater immersion. With standard air insufflation, the sigmoid colon is distended and rises with air, often leading to loop formation. By replacing air with water, the colon is weighed down and tends to assume a relatively straight configuration, which facilitates insertion. A continuous infusion of room-temperature water is achieved using the waterjet function of the colonoscope, while advancing the scope. Air pockets and fecal residue are simultaneously suctioned until only water remains in the lumen. Visualization of anatomic landmarks and gross findings, such as the appendiceal orifice, polyps, and diverticula are not compromised with this method. There are multiple variations to this method, including water temperature, volume of water injected upfront prior to advancing the scope, patient positioning, and partial underwater immersion. Clinical implicationsColonoscopies performed with the standard technique of air insufflation is considered a painful procedure. The use of conscious sedation, while often used, has risks of complications. Thus, the water immersion technique is a safe alternative in achieving higher success rates of endoscopy with minimal sedation. This is especially applicable in patients with high sedation requirements, or in patients with tenuous cardiopulmonary status. Further studies with a larger patient population are warranted to further validate the role and efficacy of the water immersion method. Colonoscopies performed with the standard technique of air insufflation is considered a painful procedure. The use of conscious sedation, while often used, has risks of complications. Thus, the water immersion technique is a safe alternative in achieving higher success rates of endoscopy with minimal sedation. This is especially applicable in patients with high sedation requirements, or in patients with tenuous cardiopulmonary status. Further studies with a larger patient population are warranted to further validate the role and efficacy of the water immersion method." @default.
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• W1971766525 date "2011-04-01" @default.
• W1971766525 modified "2023-09-26" @default.
• W1971766525 title "VHM08 Water Immersion Colonoscopy Technique" @default.
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