How is a colonoscopy performed?


Juan, can you walk us through how a colonoscopy is performed? Sure, so there are several stepswhen we perform a colonoscopy, but let me say that the first step — and the most important step — is having a good bowel prep.

Once you have good bowel prep and your stools are coming clear, then we can set you up for a colonoscopy.

So the way we do it is we bring you to a special room where we have all of our own equipment.

You're going to be monitored, to look at your vital signs,blood pressure and heart rate, and that's very important becausefor most people we provide sedation.

That means that most patients are going to be asleep during the procedure.

Having said that, some patients can be awake during the procedure if they choose to, because overall the procedure is safe and is well tolerated.

Once the patient is sedated they're going to be on the left side for most cases, some people are on the right side, but most patients are on the left side.

And then we get started with the procedure.

I usually tell my patients that they're goingto feel a pressure in their rectum because we start by doing a rectal examination.

And the idea is to look at the anus, feel the rectal sphincter, and evaluate for lesions such ashemorrhoids or rectal cancer.

Once we do that we introduce the scope through the anus, into the rectum, and then into the colon to take a look at the whole large bowel.

The idea is to take a really good look at the mucosa, or the lining of the colon.

Probably we can take about 15 to 30 minutes doing this.

And again the idea is to take a really close look behind all of the folds.

We go in looking at the bowel.

We're going to be inflating the colon slightly with air, sometimes CO2, sometimes water — and this is for us to take a good look at everything.

And then when we come back, we do the same but this time taking a closer look at all of the areas.

When we're done, the last part of the examination isto do what's called a retroflexion, which is to examine the last part of the colon, which is the rectum.

Again to look for internal hemorrhoidsor other hidden tumors.

Once we complete that we are done and the patient goes out to recovery.

Let me also add that the beauty of the test is that if you find something you can go ahead and take it out, you can go ahead and take samples.

So I do tell the patients and their family members — particularly when they're waiting,you know, in the recovery area — that the test may take a little bit longer than 15 or 30 minutes.

You know, if we found polyps: the polypsmay be small, the polyps may be big, it may take a little bit longer.

Different people have different colons, they may be a little bit loopy so they may be, technically, a little bit harder to reach the cecum — meaning the very, very beginning of the colon — the side where the small bowel joins with the colon.

So I tell them that just for them to understand that, yes, it's going to take 15 or 30 minutes, but it may take a little bit longer.

Not to worry.

The idea is to get the job done, to get a good exam, to get a good look.

And if we need to remove any polyps we're going to do it right away so you don't need to come back — which by the way, some polyps may be big.

The endoscopist may not feel comfortable taking such a big polyp, so there's a small chance that you may be one of these patients with a large polyp that needs to come back and have it removed by a different endoscopist.

Source: Youtube