title: Tapered colonoscope performs better than the pediatric colonoscope in female patients: a direct comparison through tandem colonoscopy.
abstract: BACKGROUND
  The pediatric variable-stiffness colonoscope (PVSC) is used by many endoscopists to negotiate the colon that requires a flexible colonoscope; it has a smaller diameter, but may lead to excessive looping. A prototype colonoscope tapers from an adult width to a pediatric diameter at approximately 25 cm. The tapered colonoscope (TC), while retaining the flexibility of the PVSC, has the column strength of the adult colonoscope to help negotiate the proximal colon.
  
  
  OBJECTIVE
  Our hypothesis is that use of the TC in female patients would be associated with less looping than the PVSC during the procedure, fewer required maneuvers, and thus a quicker examination.
  
  
  METHODS
  Direct comparison through tandem colonoscopies.
  
  
  METHODS
  University endoscopy suite.
  
  
  METHODS
  Forty unselected female patients.
  
  
  METHODS
  Tandem colonoscopies with PVSC and TC.
  
  
  METHODS
  Time to the cecum and the ability to retroflex in the cecum.
  
  
  RESULTS
  Compared with the PVSC, the TC had faster times to achieve cecal intubation (mean [standard deviation], 8.83+/-4.68 minutes versus 6.88+/-4.08 minutes; P=.013) and a higher rate of retroflexion in the cecum (31/40 patients vs 39/40 patients; P<.01). Use of the TC was associated with a decreased need for abdominal pressure (P<.001).
  
  
  CONCLUSIONS
  The TC achieved faster cecal intubation rates and had a higher success of cecal retroflexion than a PVSC. This performance likely was because of diminished looping and thus a decreased need for maneuvers. The TC may be preferable to the PVSC for female patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Health Science Center, Stony Brook University, Stony Brook, New York 11794-8173, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Anderson
authors.forename: Grace
authors.initials: G
authors.lastname: Walker
authors.forename: John W
authors.initials: JW
authors.lastname: Birk
authors.forename: Zvi
authors.initials: Z
authors.lastname: Alpern
authors.forename: Isabelle
authors.initials: I
authors.lastname: Von Althen
mesh_terms: D002432:Cecum / Q000033:anatomy & histology; D003106:Colon / Q000033:anatomy & histology; D020685:Colonoscopes / Q000592:standards*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D010372:Pediatrics / Q000295:instrumentation*; D018583:Pliability; D011446:Prospective Studies