Positioning the Patient

Prior to colonoscopy, the patient should be supine for examination of the abdomen. In addition to general clinical examination procedures, special attention must be paid to any surgical scars and hernias (inguinal, umbilical, or incisional hernias). At the beginning of the actual colonoscopy, the patient should be in the left lateral position, with his knees bent and pulled up. In this position, perianal inspection is possible, as is digital palpation and the insertion of the endoscope tip into the anus. Position may vary during the rest of the colonoscopy. Ileocolonoscopy can often be completed in the left lateral position without a problem (Fig.4.1a). In many patients, however, changing to the supine position after the colonoscopy has begun makes the rest of the procedure easier (Fig.4.1b). This position has the advantage of enabling external compression and "splinting" (especially for the sigmoid and transverse colon; see also Chapter 5) and it also makes localization of the endoscope easier. For "trouble spots," like passing the rectosigmoid junction or the hepatic flexure, as well as intubation of the ileocecal valve, repositioning the patient (from the left lateral position to supine or even the right lateral position) can also be helpful. The position for withdrawing the endoscope after reaching the terminal ileum depends on the examiner's preference, though most of the time it is done with the patient in the supine position (Fig. 4.1b).

Positioning For Colonoscopy

Fig. 4.1 Patient position during colonoscopy.

a Beginning of colonoscopy: patient in left lateral position.

b After changing position: the patient is supine.

Fig. 4.1 Patient position during colonoscopy.

a Beginning of colonoscopy: patient in left lateral position.

b After changing position: the patient is supine.

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Responses

  • berilac
    What position are you in for a colonoscopy?
    9 months ago
  • kauko
    How is the patient positioned durng a colonoscopy?
    5 months ago

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