Thin scope for colonoscopy?

[heiders33]

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?

[Jacques]

... 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.

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]

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.

[crikklekay]

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!

[Atoq]

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

[heiders33]

Thank you so much everyone! Very reassuring.

[boxhill]

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?