Skip to main content

Advertisement

SpringerLink
Log in

Magnifying gastroscopy using a soft black hood for difficult colonoscopy

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Various methods are reported as aids to cecal intubation for cases in which colonoscopy is difficult. This study aimed to investigate prospectively whether a gastroscope with magnification function, narrow-band imaging (NBI), and a soft black hood can aid insertion in cases of difficult colonoscopy and facilitate both accurate diagnosis and safe treatment.

Methods

This prospective study recruited 177 patients. All were examined with a magnifying gastroscope. A commercially available soft black hood was attached to the gastroscope during insertion and magnification. Difficult colonoscopy was anticipated before colonoscopy in cases of patients with at least one of the following factors: low BMI (<20 kg/m2), adhesion due to previous surgery, or previous colonoscopy that could not reach to the cecum. The success rate and duration of cecal intubation then were assessed. All detected lesions were evaluated by magnifying NBI and then classified as non-neoplastic or neoplastic for endoscopic diagnosis. Subsequently, all the lesions were removed and examined histologically for comparison.

Results

The overall success rate of cecal intubation was 100% (177/177), and the mean time taken to reach the cecum was 5.9 min. A total of 156 lesions were detected endoscopically, and the overall diagnostic accuracy of NBI with magnification was 98.7%. No associated complications occurred.

Conclusion

Magnifying gastroscopy using a soft black hood and NBI is useful for cecal intubation in cases wherein colonoscopy is difficult, facilitating accurate diagnosis and safe treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Church JM (1994) Complete colonoscopy: how often? And if not, why not? Am J Gastroenterol 89:556–560

    PubMed  CAS  Google Scholar 

  2. Mark DG, Rex DK, Lappas JC (1992) Quality of air contrast barium enema performed the same day as incomplete colonoscopy with air insufflation. Gastrointest Endosc 38:693–695

    Article  PubMed  CAS  Google Scholar 

  3. Neri E, Giusti P, Battolla L, Vagli P, Boraschi P, Lencioni R, Caramella D, Bartolozzi C (2002) Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology 223:615–619

    Article  PubMed  Google Scholar 

  4. Rex DK (2008) Achieving cecal intubation in the very difficult colon. Gastrointest Endosc 67:938–944

    Article  PubMed  Google Scholar 

  5. Arcovedo R, Larsen C, Reyes HS (2007) Patient factors associated with a faster insertion of the colonoscope. Surg Endosc 21:885–888

    Article  PubMed  Google Scholar 

  6. Leung FW (2008) Methods of reducing discomfort during colonoscopy. Dig Dis Sci 53:1462–1467

    Article  PubMed  Google Scholar 

  7. Horiuchi A, Nakayama Y, Kajiyama M, Fujii H, Tanaka N (2004) Usefulness of a small-caliber, variable-stiffness colonoscope as a backup in patients with difficult or incomplete colonoscopy. Am J Gastroenterol 99:1936–1940

    Article  PubMed  Google Scholar 

  8. Harada Y, Hirasawa D, Fujita N, Noda Y, Kobayashi G, Ishida K, Yonechi M, Ito K, Suzuki T, Sugawara T, Horaguchi J, Takasawa O, Obana T, Oohira T, Onochi K, Kanno Y, Kuroha M, Iwai W (2009) Impact of a transparent hood on the performance of total colonoscopy: a randomized controlled trial. Gastrointest Endosc 69:637–644

    Article  PubMed  Google Scholar 

  9. Hawari R, Pasricha PJ (2007) Going for the loop: a unique overtube for the difficult colonoscopy. J Clin Gastroenterol 41:138–140

    Article  PubMed  Google Scholar 

  10. Paonessa NJ, Rosen L, Stasik JJ (2005) Using the gastroscope for incomplete colonoscopy. Dis Colon Rectum 48:851–854

    Article  PubMed  Google Scholar 

  11. Wehrmann T, Lechowicz I, Martchenko K, Riphaus A (2008) Routine colonoscopy with a standard gastroscope: a randomized comparative trial in a western population. Int J Colorectal Dis 23:443–446

    Article  PubMed  Google Scholar 

  12. Uraoka T, Saito Y, Matsuda T, Sano Y, Ikehara H, Mashimo Y, Kikuchi T, Saito D, Saito H (2008) Detectability of colorectal neoplastic lesions using a narrow-band imaging system: a pilot study. J Gastroenterol Hepatol 23:1810–1815

    Article  PubMed  Google Scholar 

  13. Sano Y, Ikematsu H, Fu KI, Emura F, Katagiri A, Horimatsu T, Kaneko K, Soetikno R, Yoshida S (2009) Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc 69:278–283

    Article  PubMed  Google Scholar 

  14. Katagiri A, Fu KI, Sano Y, Ikematsu H, Horimatsu T, Kaneko K, Muto M, Yoshida S (2008) Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia. Aliment Pharmacol Ther 27:1269–1274

    Article  PubMed  CAS  Google Scholar 

  15. Ikematsu H, Matsuda T, Emura F, Saito Y, Uraoka T, Fu KI, Kaneko K, Ochiai A, Fujimori T, Sano Y (2010) Efficacy of capillary pattern type IIIA/IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms. BMC Gastroenterol 10:33

    Article  PubMed  Google Scholar 

  16. Yao K, Iwashita A, Tanabe H, Nishimata N, Nagahama T, Maki S, Takaki Y, Hirai F, Hisabe T, Nishimura T, Matsui T (2008) White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc 68:574–580

    Article  PubMed  Google Scholar 

  17. Hamilton SR, Aaltonen LA, eds (2000) Pathology and genetics: tumours of the digestive system. In: World Health Organization Classification of Tumours. IARC Press, Lyon. pp 103–143

  18. Kudo S, Lambert R, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O’Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Triadafilopoulos G, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Vieth M, Jass JR, Hurlstone PD (2008) Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 68:S3–S47

    Article  PubMed  Google Scholar 

  19. Sano Y, Ikematsu H, Fu KI, Emura F, Katagiri A, Horimatsu T, Kaneko K, Soetikno R, Yoshida S (2009) Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc 69:278–283

    Article  PubMed  Google Scholar 

  20. Hurlstone DP, Sanders DS, Thomson M, Cross SS (2006) “Salvage” endoscopic mucosal resection in the colon using a retroflexion gastroscope dissection technique: a prospective analysis. Endoscopy 38:902–906

    Article  PubMed  CAS  Google Scholar 

  21. Horiuchi A, Nakayama Y (2008) Improved colorectal adenoma detection with a transparent retractable extension device. Am J Gastroenterol 103:341–345

    Article  PubMed  Google Scholar 

  22. Kondo S, Yamaji Y, Watabe H, Yamada A, Sugimoto T, Ohta M, Ogura K, Okamoto M, Yoshida H, Kawabe T, Omata M (2007) A randomized controlled trial evaluating the usefulness of a transparent hood attached to the tip of the colonoscope. Am J Gastroenterol 102:75–81

    Article  PubMed  Google Scholar 

  23. Lee YT, Hui AJ, Wong VW, Hung LC, Sung JJ (2006) Improved colonoscopy success rate with a distally attached mucosectomy cap. Endoscopy 38:739–742

    Article  PubMed  CAS  Google Scholar 

  24. Leung FW (2008) Water-related techniques for performance of colonoscopy. Dig Dis Sci 53:2847–2850

    Article  PubMed  Google Scholar 

Download references

Disclosures

Hisashi Nakamura, Kuangi Fu, and Akihiko Yamamura have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Chofu Surgical Clinic, Tokyo, Japan

    Hisashi Nakamura

  2. Department of Gastroenterology, Juntendo University Nerima Hospital, 3-1-10 Nerima-takanodai, Nerima, Tokyo, 177-0033, Japan

    Kuangi Fu

  3. Department of Pathology, Tokyo Metropolitan Cancer Detection Center, Tokyo, Japan

    Akihiko Yamamura

Authors
  1. Hisashi Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kuangi Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akihiko Yamamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kuangi Fu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakamura, H., Fu, K. & Yamamura, A. Magnifying gastroscopy using a soft black hood for difficult colonoscopy. Surg Endosc 25, 3016–3021 (2011). https://doi.org/10.1007/s00464-011-1662-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-011-1662-9

Keywords

Search

Navigation