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Safe and Effective Abdominal Pressure During Colonoscopy

Forearm Versus Open Hand Technique

Prechel, James A., GTS; Hucke, Ray, MPH, OT

doi: 10.1097/SGA.0b013e3181972c03

Safe and effective colonoscopies may depend on several factors. The technique of the physician, effectiveness of the preparation, and the patient's previous surgeries are key factors in providing a complete colonoscopy. However, a very important aspect of providing a safe and effective colonoscopy for the patient is not only the physician's expertise, but also abdominal pressure techniques that can be provided by the assistant. These techniques, which have not been widely publicized until the last few years, will assist in anus-to-cecum surveillance of the colon. It is important to recognize that proper technique is vital to prevent injury to both the patient and the assistant providing the pressure. In this article, three techniques are discussed; however, only two are recommended. One technique (open hand) is noted as a technique that may have the potential to cause injury to the assistant. Effective and safe abdominal pressure will aid in the comfort of the patient and may shorten the time it takes to complete the procedure.

About the authors: James A. Prechel, GTS, is Instructor of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Scottsdale, Arizona.

Ray Hucke, MPH, OT, is Instructor in Physical Medicine and Rehab, College of Medicine, Mayo Clinic, and is with the Division of Preventive and Occupational Medicine, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona.

Correspondence to: James A. Prechel, GTS, Mayo Clinic, GI/Endoscopy Unit, 13400 East Shea Blvd, Scottsdale, AZ 85259 (e-mail:

Received January 12, 2008; accepted May 5, 2008.

© The Society of Gastroenterology Nurses & Associates 2009. All Rights Reserved.