Overcoming a severely angulated sigmoid colon using a clear cap: the no-air, no-water technique

Overcoming a severely angulated sigmoid colon has always been a challenge when working toward controlling pain during colonoscope insertion. At present, water-aided colonoscopy is one of the most preferred methods to achieve this goal [1]. In this study, I explored an alternative method. The method consists of maintaining the axis by rotating the colonoscope clockwise or counterclockwise every time it passes through the folds of the sigmoid colon. When using this technique, one should use a clear cap to dig out the folds; moreover, air or water should not be used to inflate the large intestine ([Video 1]). This technique allows the endoscopist to overcome the problems in navigating a severely angulated sigmoid colon with simple scope movements.

Video 1 Overcoming a severely angulated sigmoid colon using a clear cap: the no-air, no-water technique.

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• Reference

• 1 Hayman CV, Vyas D. Screening colonoscopy: the present and the future. World J Gastroenterol 2021; 27: 233-239