Colonoscopy and Flexible Sigmoidoscopy

The place of colonoscopy in clinical practice depends on local circumstances and available endoscopic expertise. Colonoscopy and flexible sigmoidoscopy achieve more than radiological imaging techniques do because of their greater accuracy and histologic and therapeutic capabilities. Obtaining full informed patient consent is essential before an invasive procedure such as colonoscopy, with its potential for adverse events. Most patients can manage bowel preparation at home, arrive for colonoscopy, and walk out shortly afterwards. Most skilled endoscopists favor the one-person “single-handed” approach, in which the colonoscopist manages the angulation controls and valves with one hand and inserts or twists the shaft with the other. However, there are many who use two hands on the angulation controls and a few experts who work successfully with the “two-person” method, using an assistant to manipulate the shaft.