Colonoscopy course for Junior Doctors (Doctors in Training)

Day 1 - 2. sal "SALEN", Svendborg Sygehus

09.00 Breakfast and arrival

09.15 Welcome and participant introductions

09.30 Session 1

                          Basic knowledge of Colonoscopy
                          Live Colonoscopy
                          A Quick Guide to improved colonoscopy technique

Coffee Break 

                       Electronic Imaging
                       Morphology & Classification
                       Electronic Imaging 
                       Morphology & Classification 
                       Techniques for Better Detection of Colorectal Neoplasia

12.30 Lunch

13.00 session 2
                         Resection of Colorectal Neoplasia ≤20 mm
                         Resection of Colorectal Neoplasia >20 mm
                         Complications
                         Antithrombotic Management
                         Summary & group discussion

13.00 Thank you for today

Session content:

Sessions: 

1. Basic Knowledge of Colonoscopy

• Anatomy of the colon

• Utilizing gravity

• Understanding loop formation

• Colonoscope technology

• Air, CO₂, or water insufflation

• Use of a cap (short distal attachment)

• Slow vs. fast movements

• Short vs. long maneuvers

• Colonoscopy vs. ileo-colonoscopy

2. A Quick Guide to Improved Colonoscopy Technique

• Loop-free intubation – what is it, and how is it achieved?

• Intubation with a short meso-sigmoid

• Intubation with a long meso-sigmoid

• Intubation of a twisted/tortuous sigmoid colon

• Navigating the left colic flexure

• Navigating the transverse colon

• Navigating the right colic flexure

3. Techniques for Better Detection of Colorectal Neoplasia

• Withdrawal techniques

• Withdrawal duration and pattern recognition

• Retroflexion in the right colon or re-intubation

• Use of anticholinergic drugs

• Dynamic positioning

• Removing or marking diminutive polyps during intubation

• Technologies for improved visualization (Caps, Endocuff, etc.)

4. Electronic Imaging

• "Image-enhanced endoscopy"

• Virtual chromoendoscopy

• NBI, BLI+LCI, FICE, i-Scan

• Optimization of photo documentation)

5. Description of Findings 1

• Paris classification

• NICE classification

• WASP criteria

• LSTs (Laterally Spreading Tumors)

6. Resection of Colorectal Neoplasia ≤20 mm

• Polypectomy with biopsy forceps

• Cold snare polypectomy

• Hot snare polypectomy

• Hot snare polypectomy (long, thin, and floppy stalk)

• Clip-assisted hot snare resection of stalked polyps

• Use of EndoLoop

• Saline-assisted polypectomy (mini-EMR)

• Hemostasis techniques

• Basic knowledge of ESUs (Electrosurgical Units)

8. Resection of Colorectal Neoplasia > 20 mm

• Assessment of risk for submucosal invasive cancer (SMIC risk)

• EMR technique and devices

• EMR en-bloc

• EMR piece-meal

• Hybrid EMR

• ESD (Endoscopic Submucosal Dissection)