Comparison of the Left-Lateral Horizontal and Supine Positions for Colonoscopy Intervention: A Randomized Controlled Study

Objective: One of the most common technical difficulties during colonoscopy is passing through the fold of the sigmoid colon. Colonoscopy is commonly performed by endoscopists with the patient in the left lateral position. When the procedure is initiated in the left lateral position, insufflation of the bowel may result in a sharper angulation of the sigmoid colon, making advancement of the colonoscope more difficult. This study aimed to compare colonoscopic procedures initiated in the left lateral position and the supine position.

Materials and Methods: Colonoscopy was performed on 198 participants who had an indication for colonoscopy at the General Surgery clinic and met the study inclusion criteria. All procedures were conducted by the same endoscopist (Dr. Semra Tutcu Şahin) in the Endoscopy Unit during working hours. Participants were randomly assigned to two groups:

Group 1: Participants whose starting position for colonoscopy was supine (n=97) Group 2: Participants whose starting position for colonoscopy was left lateral (n=101)

During colonoscopy, participants' demographic data, vital signs, and the time required for the endoscopist to reach the cecum were recorded. At the end of the procedure, participants completed a pain scale, and the endoscopist completed an observation scale. The data were entered into the SPSS program and analyzed.

Inclusion criteria

• Female and male patients over 18 years of age who have been medically indicated for colonoscopy and have signed the voluntary consent form.

Exclusion criteria

• Patients under 18 years of age
• Patients who do not give informed consent
• Pregnant women
• Patients requesting sedation
• Patients with an indication for emergency colonoscopy
• Patients with a history of colon resection
• Major psychiatric disorders