title: Observational study of the frequency of use and perceived usefulness of ancillary manoeuvres to facilitate colonoscopy completion.
abstract: BACKGROUND
  A paucity of information exists regarding the frequency of use and usefulness of ancillary manoeuvres such as applying abdominal pressure and changing patient position to successfully complete colonoscopy. This information would be useful to understand and improve colonoscopy technique.
  
  
  OBJECTIVE
  We sought to determine the frequency, type and perceived success of ancillary manoeuvres used when performing colonoscopy during routine clinical practice.
  
  
  METHODS
  A prospective, observational study was conducted at an outpatient endoscopy centre with a diverse group of colonoscopists. Our hypothesis was that ancillary manoeuvres would be used frequently by endoscopists of varying levels of experience and would be helpful in achieving successful caecal intubation. Information collected included patient and staff characteristics, procedural information and use of ancillary manoeuvres. Additional descriptive information was obtained when a manoeuvre was performed.
  
  
  RESULTS
  One thousand three hundred and twenty-seven patients participated (691 women; mean age 62.5+/-12.3). The caecum was reached in 94% of cases. One or more ancillary manoeuvres were used in 73% of cases. Whilst one or two manoeuvres were helpful to achieve caecal intubation, increased manoeuvres were associated with an increased risk of incomplete colonoscopy.
  
  
  CONCLUSIONS
  These data suggest that ancillary manoeuvres are used frequently but are not necessarily predictive of successful caecal intubation. Additional data from prospective, randomised studies are needed to address the overall utility and optimal application of individual manoeuvres.
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: S L
authors.initials: SL
authors.lastname: Hansel
authors.forename: J A
authors.initials: JA
authors.lastname: Prechel
authors.forename: B
authors.initials: B
authors.lastname: Horn
authors.forename: M D
authors.initials: MD
authors.lastname: Crowell
authors.forename: J K
authors.initials: JK
authors.lastname: DiBaise
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D056888:Patient Positioning; D011446:Prospective Studies