Small caliber overtube-assisted colonoscopy

AIM To combine the benefits of a new thin flexible scope with elimination of excessive looping through the use of an overtube.METHODS Three separate retrospective series. Series 1 25 consecutive male patients undergoing unsedated colonoscopy using the new device at a Veteran's hospital in the United States. Series 2 75 male patients undergoing routine colonoscopy using an adult colonoscope, pediatric colonoscope, or the new device. Series 3 35 patients who had incomplete colonoscopies using standard instruments.RESULTS Complete colonoscopy was achieved in all 25 patients in the unsedated series with a median cecal intubation time of 6 min and a median maximal pain score of 3 on a 0-10 scale. In the 75 routine cases, there was significantly less pain with the thin scope compared to standard adult and pediatric colonoscopes. Of the 35 patients in the previously incomplete colonoscopy series, 33 were completed with the new system.CONCLUSION Small caliber overtube-assisted colonoscopy is less painful than colonoscopy with standard adult and pediatric colonoscopes. Male patients could undergo unsedated colonoscopy with the new system with relatively little pain. The new device is also useful for most patients in whom colonoscopy cannot be completed with standard instruments.