The Effect of Colonoscopy Starting Position on Procedural Efficiency
The Effect of Colonoscopy Starting Position on Procedural Efficiency
The main questions it aims to answer are:
Does starting colonoscopy in the supine position compared with the left lateral position affect the time required to reach the cecum? Does the starting position affect endoscopist comfort, patient comfort, procedure duration, polyp and adenoma detection, or the need to change the patient's position during the procedure?
Participants will be randomly assigned to undergo colonoscopy starting either in the supine position or in the left lateral position. The colonoscopy will otherwise be performed according to standard clinical practice.
Colonoscopy is widely used for the diagnosis, screening, and surveillance of colorectal diseases. The left lateral position is conventionally used as the initial patient position during colonoscopy; however, alternative starting positions may influence colonoscope advancement, procedure efficiency, and the comfort of both the patient and the endoscopist.
This single-center, randomized controlled trial was designed to evaluate the effect of the starting position on colonoscopy efficiency. Adult participants undergoing elective colonoscopy were randomly assigned in a 1:1 ratio to begin the procedure either in the supine position or in the left lateral position.
The primary focus of the study was endoscopist comfort during the procedure. Additional assessments included patient comfort, cecal intubation time, withdrawal time, adenoma and polyp detection, the need for patient repositioning during colonoscopy, and procedure-related complications.
The study aimed to determine whether the supine starting position provides advantages over the conventional left lateral starting position and whether the initial patient position may represent a simple and readily applicable factor for improving colonoscopy efficiency.
Inclusion Criteria:
Adults aged 18 years or older. Scheduled to undergo screening colonoscopy. No history of colorectal cancer. No history of colorectal surgery.
Exclusion Criteria:
Failure to achieve cecal intubation. Inflammatory bowel disease. Inadequate bowel preparation, defined as a Boston Bowel Preparation Scale (BBPS) score <2.