RU-2861504-C1 - COLONOSCOPY METHOD

Abstract

FIELD: medicine. SUBSTANCE: invention relates to endoscopy, coloproctology, and can be used for performing colonoscopy during examination of the large intestine. After bringing the colonoscope to an acute angle of the intestine, a flexible endoscopic retractor is passed into the instrumental channel of the colonoscope, as in fig. 1. Then, manipulating the distal end of the colonoscope, aiming the endoscopic retractor towards the intended bend of the intestine, blindly extending the retractor to the maximum possible length until it stops. Then, opening the retractor until resistance is felt on the instrument handle, and fixing the intestine. Pulling the retractor towards oneself until the intestinal lumen appears, then folding the retractor and removing it into the instrumental channel, and passing the colonoscope more proximally into the intestine. EFFECT: possibility of passing acute angles and straightening the intestine, which simplifies examination in cases of pronounced tortuosity or loop formation and reduces the risk of injury, due to its effective shortening and fixation using a retractor. 1 cl, 9 dwg, 1 ex

Inventors

• Bashirov Ramil Azer ogly

Dates

Publication Date

20260505

Application Date

20250723

Claims (1)

1. A method of colonoscopy, including the insertion of a colonoscope, straightening and shortening of the intestine, characterized in that after the colonoscope is brought to an acute angle of the intestine, a flexible endoscopic retractor is inserted into the instrument channel of the colonoscope, as in Fig. 1, then, manipulating the distal end of the colonoscope, the endoscopic retractor is directed towards the suspected bend of the intestine, the retractor is blindly withdrawn to the maximum possible length until it stops, then the retractor is opened until resistance is felt on the handle of the instrument and the intestine is fixed, the retractor is pulled towards oneself until the lumen of the intestine appears, then the retractor is folded and removed into the instrument channel, and the colonoscope is inserted proximally into the intestine.

Description

The invention relates to the field of medicine, namely to intraluminal diagnostic endoscopy, and is used as an alternative to the conventional technique of performing colonoscopy in examining the large intestine. Colonoscopy is an intraluminal endoscopic examination of the colon using a flexible instrument called an endoscope. Colonoscopy allows for the visual diagnosis of inflammatory bowel diseases (UC, Crohn's disease, etc.), submucosal and epithelial neoplasms (polyps, tumors), and the assessment of the mucosal condition, vascular pattern, and anatomical features of the colon. Timely detection and removal of adenomatous colon polyps has been shown to reduce mortality from colorectal cancer. Modern colonoscopy techniques rely on shortening (constricting) the intraperitoneal colonic sections: the sigmoid and transverse colon. Failure to adhere to this technique leads to the formation of additional angles in the mobile sections of the colon, which, in turn, can become more acute. The colon stretches and twists, making colonoscopy difficult, and sometimes impossible. The bowel retraction technique is based on frequent retraction of the endoscope and aspiration of air from the lumen, as well as straightening and shortening the bowel using the endoscope. This technique was chosen as the prototype. However, in some clinical cases, such as complex colon anatomy (dolichosigma), severe adhesions in the abdominal cavity, performing colonoscopy with the bowel collection technique is difficult, which is a pressing issue given the number of screening colonoscopies performed. The objective of the invention is to increase the efficiency of performing endoscopic examination of the colon. The technical result consists in providing the possibility of endoscopic examination of the large intestine with complex anatomical features of the intestine and with pronounced adhesions in the abdominal cavity. This is achieved due to the fact that in the proposed method of performing colonoscopy, a flexible endoscopic instrument, a retractor (Fig. 1, Fig. 4), is used to retract the intraperitoneally located sections of the large intestine, which ensures the capture, pulling up and shortening of the intestine in order to straighten it and pass through sharp angles. Images explaining the essence of the invention: Fig. 1 - endoscopic retractor for collecting the colon Fig. 2, Fig. 3 - endoscopic retractor for collecting small intestine Fig. 4 - endoscopic retractor in the working (open) position in the frontal projection Fig. 5 - the endoscopic retractor is blindly inserted through the acute angle of the intestine to the maximum possible length Fig. 6 - the endoscopic retractor is opened until resistance appears Fig. 7 - the endoscopic retractor is pulled up as much as possible, the angle is smoothed out, the intestine is collected Fig. 8, Fig. 9 - example of using an endoscopic retractor When standard retracting techniques are ineffective in anatomically complex colons, a flexible endoscopic instrument called a retractor is used to navigate turns. The endoscopic retractor has a proximal handle and a distal section consisting of parallel flexible strings that fold into fingers when in use, resembling the spokes of an open umbrella. These strings serve as a supporting and gripping mechanism. The retractor ends in a rounded tip, eliminating the risk of perforation when pressed against the intestinal wall. The proposed method for performing a colonoscopy consists of the following steps: Under visual control, the endoscope is advanced to the desired angle. An endoscopic retractor is inserted into the colonoscope's instrument channel. Using the distal end of the endoscope, the endoscopic retractor is directed toward the suspected bowel kinking. The flexible retractor is then blindly advanced to its maximum length until it stops (Fig. 5), after which the instrument is opened until resistance is encountered (Fig. 6). The force exerted by the retractor's fingers on the colon wall is felt on the handle of the opening instrument, allowing this pressure to be controlled. Having secured the colon in this position, the retractor is gradually and carefully pulled toward the colonoscope until a lumen appears (Fig. 7). By smoothing the angle, the colon is straightened and shortened. The retractor is then retracted into the instrument channel, and the endoscope is advanced proximally into the colon. An endoscopic retractor can be used to collect small bowel loops when performing enteroscopy (Fig. 2, Fig. 3). Video colonoscopy Preparation: R-2, T-3, L-2. The sphincter is tonic. The colonoscope is advanced into the dome of the cecum and then 15 cm proximal to the Bauhinian valve into the ileum. The sigmoid colon is distinctly looped, forming a fixed reverse alpha loop (most likely due to severe adhesions in the pelvis), and is passed by sweeping with an endoscopic retractor (Fig. 8, Fig. 9) on the left side. The mucosa of the small intestine is unchanged.