Thin scope for colonoscopy?

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heiders33
Posts: 347
Joined: Sat Nov 04, 2017 11:08 am

Thin scope for colonoscopy?

Postby heiders33 » Tue Aug 20, 2019 6:18 am

I am tentatively scheduled for my annual colonoscopy on September 16. I had a colonoscopy last October with my colorectal surgeon, but he couldn't get past the sigmoid area for fear of puncturing the colon because of its post-surgical shape. (I had a Low Anterior Resection in Sep 2017). So this upcoming colonoscopy is at Memorial Sloan Kettering and they said they will use a thinner scope. I don't know yet what doctor will be performing the scope, and I plan to ask many questions, but I want to know if anyone here has experienced this and what I should expect. I am very nervous -- I want to have the test, but I also don't want them to do any damage. What questions should I ask? Anyone have any experiences with thinner scopes that you would be willing to share?
36 year-old female
May 2017: Dx rectal cancer T3N2M0
MSS, KRAS G12D
6/17: 28 days chemorad
9/17: LAR/loop ileostomy
10/17 - 2/18: XELOX six rounds
3/18: reversal
5/18: CT liver spot, blood counts normal
8/18: Abnormal PET, CEA 2.4
9/18: liver resection/HAI pump
10/18: Clear CT/sigmoidoscopy
10/18 - 4/19: 6MO FUDR/5FU
7/19 - Clear CT

Jacques
Posts: 497
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: Thin scope for colonoscopy?

Postby Jacques » Tue Aug 20, 2019 7:20 am

heiders33 wrote:... Any experiences with thinner scopes that you would be willing to share?

Maybe what they mean by "thinner scope" is a pediatric scope??? But if they get through with a pediatric scope maybe the scope will not be long enough to reach all the way to the caecum.

O Stoma Mia wrote:
JudeD59 wrote:I'm the type person who has less anxiety if I have a very clear picture of what to expect with procedures. I'm scheduled for my leak test on February 10th, so if anyone would be willing to take the time to give a detailed description of exactly what to expect, I would greatly appreciate it...

The leak-test session had two objectives:
  1. Anastomosis patency check: In this phase, they try to determine if the anastomosis has a large-enough opening. Phase 1. In this phase, they give a mild sedative and use a small pediatric colonoscope to see if it is possible for the small colonoscope to reach the other side of the anastomosis. In other words, it is a check to see if the anastomosis has any opening at all, or if it has been completely closed off by scar tissue or adhesions. If this test is successful (i.e., they are able to push the pediatric colonoscope through to the other side) they then proceed to Phase 2. In Phase 2 they increase the dose of the sedative so that the patient won't feel anything from this point onward. After the sedative has taken effect, they then attempt to pass a normal-size adult colonoscope through the opening that they just found earlier using the pediatric colonoscope. If they manage to get the adult colonoscope to go all the way through, then the test is successful. If not, then the test fails and they postpone the reversal until they can do something about increasing the size of the opening. (The opening must be large enough to accommodate an adult colonoscope, because colonoscopies will be required later on, and every three years subsequently. If the opening is not large enough, they will need to do the repairs now, not later.)
  2. Leak test: If the above tests are successful, then they do the set-up for the leak test. I think the way it works is like this (but I don't know for sure, since I was under heavy sedation from this point onward): They insert a special catheter that has an inflatable balloon at the end. When they inflate the balloon, the catheter then serves as a plug that prevents anything from coming out during the leak test. They then use the catheter to force contrast solution up into the rectal area, far enough to fill up the anastomosis and the neo-rectum area. When this part of the colon/rectum is full of contrast solution, then they use some kind of portable X-ray machine or fluoroscope to check whether any of the contrast liquid has escaped from the colon. If they don't see any leaks on the image, they then release the clamp on the catheter to allow the contrast fluid to escape. After all of the fluid has drained out, they then deflate the balloon completely so that they can gently remove the catheter. I think they also have something like a bed-pan there to handle any fluid that may come out after the catheter has been removed. The nurses handled all of the clean up necessary, and when I finally woke up from the anaesethesia, the doctor told me that the test had been successful and that I was ready to be discharged.

    This is what I remember about my experience. It may be a different procedure in your case.

heiders33
Posts: 347
Joined: Sat Nov 04, 2017 11:08 am

Re: Thin scope for colonoscopy?

Postby heiders33 » Tue Aug 20, 2019 8:49 pm

Thanks, this is helpful. I did have those procedures done before my reversal. But when my colorectal surgeon went to do my colonoscopy eight months later, there was something about the shape of my colon that made him stop. I’m going to have him speak directly to the GI doc who will perform my colonoscopy.
36 year-old female
May 2017: Dx rectal cancer T3N2M0
MSS, KRAS G12D
6/17: 28 days chemorad
9/17: LAR/loop ileostomy
10/17 - 2/18: XELOX six rounds
3/18: reversal
5/18: CT liver spot, blood counts normal
8/18: Abnormal PET, CEA 2.4
9/18: liver resection/HAI pump
10/18: Clear CT/sigmoidoscopy
10/18 - 4/19: 6MO FUDR/5FU
7/19 - Clear CT

crikklekay
Posts: 92
Joined: Thu Feb 15, 2018 9:47 am
Location: Richmond, VA

Re: Thin scope for colonoscopy?

Postby crikklekay » Wed Aug 21, 2019 10:22 am

My husband initially only had a partial colonoscopy in the hospital because the tumor was blocking his colon (and thusly why we ended up there), so he had to get a complete colonoscopy months later. Unfortunately his stoma had shrunk a ridiculous amount and there was no way a normal scope would fit, so his gastro doctor scheduled him at the hospital. Apparently they had a scope less than 10 mm in diameter (as that was the size of his stoma) and were able to complete the colonoscopy. Maybe they are using something like that? It went really well for my husband, so I hope it will go well for you too!
Caring for DH John, 41
DX: Colon Cancer, Sigmoid colon
Tumor type: Adenocarcinoma
Tumor grade: G2, Moderately differentiated w/invasion of visceral peritoneum
Stage IIIC
Positive lymph nodes: 6/22
Chemotherapy: FOLFOX (6)
12/17 ER and emergency surgery
02/18 Hospital w/ MSSA infected port, PICC line inserted, abdominal CT scan clear chest CT scan showed septic emboli & blood clots
03/18 Hospital w/ CDIFF
04/18 Chest CT scan clear
06/18 Colonoscopy Clear
08/18 CT Scan Clear, NEMD
06/19 Colonoscopy Clear

User avatar
Atoq
Posts: 342
Joined: Wed Oct 25, 2017 9:31 am

Re: Thin scope for colonoscopy?

Postby Atoq » Wed Aug 21, 2019 9:54 pm

Hi, I had a colonscopy in November and they used a thinner scope because of the multiple surgeries. I did not have any sedation or painkillers and it was quick and pain free.

All the beat

Claudia
45 year old, mother of 2
Dx rectal cancer 10.2017
T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch neg
CEA 1.8
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, stage IV
07.05.18 CAT scan, lung met 11 mm
04.06.18 ileo reversal
26.06.18 wedge VATS
24.08.18, 31.02.19 CAT scan
12.09.18, 06.02.19 scope, CEA 1.6
19.11.18 colonscopy
20.08.19 CAT, eco
13.09.19 scope, CEA 1.2

heiders33
Posts: 347
Joined: Sat Nov 04, 2017 11:08 am

Re: Thin scope for colonoscopy?

Postby heiders33 » Thu Aug 22, 2019 6:30 am

Thank you so much everyone! Very reassuring.
36 year-old female
May 2017: Dx rectal cancer T3N2M0
MSS, KRAS G12D
6/17: 28 days chemorad
9/17: LAR/loop ileostomy
10/17 - 2/18: XELOX six rounds
3/18: reversal
5/18: CT liver spot, blood counts normal
8/18: Abnormal PET, CEA 2.4
9/18: liver resection/HAI pump
10/18: Clear CT/sigmoidoscopy
10/18 - 4/19: 6MO FUDR/5FU
7/19 - Clear CT

boxhill
Posts: 336
Joined: Fri Apr 06, 2018 11:40 am

Re: Thin scope for colonoscopy?

Postby boxhill » Thu Aug 22, 2019 9:00 pm

It has been over a year since my right hemicolectomy, and no one has ever mentioned my ever having a colonoscopy. Next time I see my oncologist, I'll ask him about it. I mean, obviously the concern has been with trying to eliminate metastatic disease, but I wonder if those of us with right hemis ever have routine colonoscopies later on?
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28
7/9/18 CT NED
11/20/18 CT NED. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met? and 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/5/19 Triphasic CT LN and spleen normal, Liver node stable
6/28/19 Pause Keytruda, predisone for joint pain
7/31/19 Restart Keytruda
9/10/19 CT stable


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