Abstract
Background and study aim Magnetic imaging technology is of proven benefit to trainees in colonoscopy, but
few studies have examined its benefits in experienced hands. There is evidence that
colonoscopy is more difficult in women. We set out to investigate (i) associations
between the looping configurations in the proximal and distal colon and (ii) differences
in the looping prevalence between the sexes. We have examined their significance in
terms of segmental intubation times and position changes required for the completion
of colonoscopy.
Patients and methods We analyzed 103 consecutive synchronized luminal and magnetic image videos of diagnostic
colonoscopies with normal anatomy undertaken by a single experienced operator.
Results Deep transverse loops and sigmoid N-loops were more common in females. A deep transverse
loop was more likely to be present if a sigmoid alpha-loop or N-loop had formed previously.
Patients with sigmoid N-loops were turned more frequently from left lateral to supine
before the sigmoid-descending junction was reached, but there was no statistical correlation
between completion time and looping pattern.
Conclusions This study has reexamined the prevalence of the common looping patterns encountered
during colonoscopy and has identified differences between the sexes. This finding
may offer an explanation as to why colonoscopy has been shown to be more difficult
in females. Although a deep transverse loop following a resolved sigmoid alpha-loop
was the most commonly encountered pattern, no statistical correlation between completion
time and looping pattern could be shown. It is the first study to examine segmental
completion times using a magnetic imager in expert hands.
