Review
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World J Gastroenterol. Dec 7, 2014; 20(45): 16984-16995
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16984
Colonoscopy procedural skills and training for new beginners
Seung-Hwa Lee, Young-Kyu Park, Duck-Joo Lee, Kwang-Min Kim
Seung-Hwa Lee, Duck-Joo Lee, Kwang-Min Kim, Center for Health Promotion, Ajou University School of Medicine, Suwon 443-380, South Korea
Young-Kyu Park, Center for Health Promotion, Bundang Jesaeng Hospital, Seongnam 463-774, South Korea
Author contributions: Lee SH and Park YK contributed in study concept and design, acquisition of data, and drafting of the manuscript; Lee SH, Park YK and Kim KM were involved in acquisition, ascertainment of data, and revision of manuscript; Lee DJ contributed to critical revision of manuscript for important intellectual content, and overall study supervision; all the authors read and approved the final draft of this manuscript.
Correspondence to: Duck-Joo Lee, MD, PhD, Professor, President, Center for Health Promotion, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon 443-380, South Korea. fmdr@medimail.co.kr
Telephone: +82-31-2197164 Fax: +82-31-2195561
Received: April 25, 2014
Revised: June 25, 2014
Accepted: August 13, 2014
Published online: December 7, 2014
Processing time: 228 Days and 19 Hours
Abstract

The incidence of colorectal cancer has been increasing in the developed world including South Korea and China. Colonoscopy allows for greater diagnostic specificity and sensitivity compared with other types of examinations, such as the stool occult blood test, barium enema, and computed tomography colonography. Therefore, in recent years, the demand for colonoscopies has grown rapidly. New beginners including primary care physicians may help meet the increasing demand by performing colonoscopies. However, it is a challenge to learn the procedure due to the long learning-curve and the high rate of complications, such as perforation and bleeding, as compared to gastroscopy. Thus, considerable training and experience are required for optimal performance of colonoscopies. In order to perform a complete colonoscopic examination, there were a few important things to learn and remember, such as the position of examinee (e.g., left and right decubitus, supine, and prone) and examiner (two-man method vs one-man standing method vs one-man sitting method), basic skills (e.g., tip deflection , push forward and pull back, torque, air suction and insufflation), advanced skills (e.g., jiggling and shaking, right and left turn shortening, hooking, and slide-by technique), assisting skills (e.g., position change of examinee, abdominal compression, breathing-holding, and liquid-infusion technique), and intubation techniques along the lower gastrointestinal tract. In this article, we attempt to describe the methods of insertion and advancement of the colonoscope to the new beginners including primary care physician. We believe that this article may be helpful to the new beginners who wish to learn the procedure.

Keywords: Colonoscopy; Beginner; Training; Procedural skills

Core tip: The demand for colonoscopy has been increasing every year. However, it is a challenge to learn the procedure due to its long learning curve and high rate of complications. Therefore, care must be taken in teaching, learning and practicing the procedure. Also, there are a few important things to learn and remember, such as the positions of the examinee and the examiner, basic skills, advanced skills, assisting skills, and intubation techniques along the lower gastrointestinal tract.