Trendelenberg Versus Left Lateral Position for Colonoscopy



Status:Recruiting
Conditions:Gastrointestinal
Therapuetic Areas:Gastroenterology
Healthy:No
Age Range:18 - Any
Updated:4/29/2016
Start Date:July 2015
End Date:August 2016
Contact:Dayna S Early, MD
Email:DEARLY@DOM.wustl.edu
Phone:314-454-5960

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The Impact of Trendelenberg Positioning as Compared to Left Lateral Positioning on Ease of Colonoscope Insertion During Colonoscopy

The purpose of this study is to determine if the trendelenberg (TD) position (position in
procedures that involves placing the patient at an angle so that their head is lower than
their feet on the procedure bed) in select patients undergoing colonoscopy is superior than
the left lateral (LL) position (patient laying on their side, traditionally used for
colonoscopies) in terms of decreasing time necessary to pass the colonoscope through the
left colon, and decreasing the difficulty of the procedure.

The colonoscopists will be asked to rate their prediction of difficulty of the procedure
prior to the colonoscopy and to rate the ease of procedure after the colonoscopy. The
clinical experience of the study investigators is that TD positioning is superior to LL
positioning in patients with risk factors for having a difficult colonoscopy (thin women;
those with diverticulosis- small bulging pouches present in the colon; or prior pelvic
surgery).

Patients with risk factors for difficult colonoscopy will be randomized to undergo
colonoscopy while positioned in the TD position or the LL position during advancement of the
colonoscope through the sigmoid colon. The sigmoid colon is a section of the colon, proximal
to the rectum, that is curved. The sigmoid colon is a normal component of GI tract anatomy,
although due to it's shape, especially with the risk factors listed previously; can cause
challenges to inserting the colonoscope.

Inclusion Criteria:

1. Personal history of pelvic surgery

2. Diverticulosis, identified by patient report or review of previous colonoscopy or
imaging studies.

3. BMI < 25.

Exclusion Criteria:

1. Patients who do not meet inclusion criteria.

2. Patients who have undergone colonic resection

3. Patients with glaucoma

4. Patients with uncontrolled acid reflux disease or active nausea/vomiting.

5. Patients who are unwilling or unable to consent.

6. BMI > 30
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St Louis, Missouri 63110
Phone: 314-454-5960
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