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Adopting the Water Method: Lessons, Tips, and Pitfalls Learned

Abstract

After studying the literature, an experienced traditional colonoscopist achieved proficiency using the water method and documented his progress with two groups: the first 20 patients and a subsequent group of the next 25 patients. Cecal intubation rates and procedure-related outcomes were compared with a retrospective, control group consisting of 100 consecutive patients who had undergone traditional colonoscopy. Cecal intubation for the first 20 patients averaged almost 10 minutes. The average time for the next 25 patients was 7.8 minutes. The air insufflation group required an average of 5.8 minutes for cecal intubation. In the second, fewer patients required change in their position (8% vs. 30%) and external pressure (12% vs. 30%) as an aid to insertion. In sedated patients examined by an experienced traditional colonoscopist, the water method can be learned quickly.