CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(07): E985-E989
DOI: 10.1055/a-1196-1711

Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

Sergio Cadoni
 1  CTO Hospital, Digestive Endoscopy Unit, Iglesias, Italy
Sauid Ishaq
 2  Russell Hall, Dept. of Gastroenterology, Birmingham, United Kingdom
 3  Birmingham City University, Birmingham, United Kingdom
Cesare Hassan
 4  Nuovo Regina Margherita Hospital, Gastroenterology, Italy
Pradeep Bhandari
 5  Portsmouth University Hospital, Dept. of Gastroenterology, Portsmouth, United Kingdom
Helmut Neumann
 6  University Medical Center Mainz, Interventional Endoscopy Center, I. Medizinische Klinik und Poliklinik, Mainz, Germany
Toshio Kuwai
 7  National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Gastroenterology, Kure, Japan
Noriya Uedo
 8  Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan
Adolfo Parra-Blanco
 9  NIHR Nottingham Digestive Diseases Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Gastroenterology, Nottingham, United Kingdom
Chris J.J. Mulder
10  VU University Medical Center, Dept. of Gastroenterology, Arnhem, Netherlands
Kenneth F. Binmoeller
11  California Pacific Medical Center, California, United States
Felix W. Leung
12  Veteran Affairs Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center, California, United States
13  David Geffen School of Medicine at UCLA, Medicine, North Hills, California, United States.
› Author Affiliations


Background and aim As the post-peak phase of the epidemic is approaching, there is an urgent need of an action plan to help resume endoscopy activity. To manage the Covid-19 pandemic-imposed backlog of postponed colonoscopy examinations, an efficient approach is needed. The practice of on-demand sedation with benzodiazepines and/or opiates will allow most patients to complete a water-aided examination with minimal or no sedation. Other methods reported to minimize patient discomfort during colonoscopy can be used, in addition to water-aided techniques. Unsedated or minimally sedated patients who do not require recovery or require a shorter one allow rapid turnaround. The practice obviates the need for assistance with deep sedation from anesthesiologists, who may be in short supply. Trainee education in water-aided colonoscopy has been demonstrated to confer benefits. This review provides some insights into the impact of Covid-19 on endoscopy services, challenges ahead, and possible solutions to help recovery of colonoscopy work and training.

Publication History

Received: 19 May 2020

Accepted: 05 June 2020

Publication Date:
24 June 2020 (online)

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