The Value of the Trendelenburg Position During Routine Colonoscopy: A Pilot Study.

Study Overview
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Brief Summary
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Colonoscopy is a procedure commonly performed to screen for colon cancer and to look for and remove colon polyps. It involves inserting a flexible tube, equipped with a video-camera at the tip, through the colon. The insertion process can be difficult in some patients, resulting in an uncomfortable and lengthy procedure.We postulate that raising the foot of the bed so that the stretcher forms a 15 degrees angle with the floor (Trendelenburg position) may make the colonoscopy easier and more comfortable to the patient.

Detailed Description
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Colonoscopy is a procedure commonly performed to screen for colon cancer and to look for and remove colon polyps. It involves inserting a flexible tube, equipped with a video-camera at the tip, through the colon. The insertion process can be difficult in some patients, resulting in an uncomfortable and lengthy procedure. Colonoscopy procedures are typically started with the patient positioned on their left side. If there is later difficulty advancing the colonoscope, the patient is shifted to other positions (e.g. back, right side, prone). We postulate that raising the foot of the bed so that the stretcher forms a 15 degrees angle with the floor (Trendelenburg position) may make the colonoscopy easier and more comfortable to the patient. This is a position commonly used in gynecologic surgery. This is a pilot project for us to gain experience with doing colonoscopy this way. The enrolled patient will be assigned randomly to 2 groups: one in the standard left lateral position and one in the 15 degree Trendelenberg position. We will be collecting data regarding the procedure from each group in the form of questionnaire and data sheet which will be filled during or at the conclusion of the procedure.

Official Title
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The Value of the Trendelenburg Position During Routine Colonoscopy: A Pilot Study.

Conditions
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Colonoscopy

Intervention / Treatment
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* Procedure: Trendelenburg position
* Procedure: Standard care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient age between 18-75 years old. Colonoscopy performed for polyp surveillance or colon cancer screening purposes. Patient able to provide informed consent. Exclusion Criteria: History of colon resection History of inflammatory bowel disease Pregnancy History of ischemic optic neuropathy or glaucoma Patient unable to provide informed consent Patients who did not fast for ≥2 hours prior to presenting for the procedure

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trendelenburg position<br>The endoscopist places the patient in 15° Trendelenberg position immediately prior to the initiation of the colonoscopy. | Procedure: Trendelenburg position<br>* The patient will be placed in the Trendelenburg position with a 15 degree angle of inclination<br>* Other names: Head-Down Tilt;|
| Other: Standard care<br>The patient will have colonoscopy in the standard horizontal position | Procedure: Standard care<br>* The patient will be placed in the standard horizontal position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The time of the procedure from the insertion of the colonoscope until the cecal base is reached |  | This outcome is measured when the cecum is intubated during a colonoscopy |