Colonoscopy difficulties & solutions.

1. Colonoscopy: How to increase its role in diagnosing/ prevention of CRC.

2. Colonoscopy: Solutions & advances. Objectives of colonoscopy. Difficulty of colonoscopy. Summary. 1 2 3 4

5. Difficult colonoscopy: causes Colooscopist factors Patient factors Both Canadian J of GE: August 2007 .

6. Colonoscopist factors: Experience Timing Training Practice volume: Factors Morning vs evening, Early vs late work hours. Manual dexterity. Better with high volume practices. Experience Training/manual dexterity Practice volume Timimg

7. Patient factors: Female SEX: More long, tortuous angulated colon. No ideal BMI: Too fat or too thin. Diverticular disease Previous operation with adhesions. Patient factors:

8. Colonoscopist & patient factors: Preparation: Need good patient-doctor cooperation. Loops & Angulations: Too much air insufulations. Less patient cooperation. Loops are the enemies of colonoscopy. Sedation failure: Doctor or patient factors.

10. Solutions for successful colonoscopy:

12. Thank You! Dr.Mohammad Shaikhani. Assistant professor. Sulaimani Univerity. College of Medicine. Iraqi Kurdistan. [email_address]