Today we are going to present our visitors with one of the recent medical advances that will make a medical procedure easier and “better.” We are talking about the colon exam or the colonoscopy. There are now two versions – the optical (old) and the virtual (new, aka CT colonographies). But if you want the new version you are going to have to ask for it because, well, because changing from old to new can present some obstacles.
There are three very important and significant differences between the two methods and the advantages are primarily with the virtual. Read carefully because these are the reasons you should discuss this method with your doctor.
A virtual colonoscopy (CT colonography) does NOT require anesthesia – an optical colonoscopy does. With the virtual method you can drive yourself to the medical facility and back home without any concern – there is no need for a taxi or other driver and you remain mentally alert.
A virtual colonoscopy only requires a few minutes to complete the procedure. The optical version will consume a full day, because of the anesthesia.
Both methods require the patient to drink solutions of strong laxatives to cleanse the intestines. And patients are limited to liquids for certain time periods before the exam. However, the virtual method generally requires a less intensive preparation regime.
The virtual method uses a CT scanner to “see” the patient’s body from the lungs to the pelvic area. More organs and a greater area of the body is analyzed with the virtual method. This has led to the detection of various undetected medical conditions in patients such as lung cancer, liver cysts, and cancer of the pancreas. Early detection of these conditions can greatly improve the survival rate of patients and these detections almost never occur with the older optical method.
The virtual method is far less invasive. It actually consists of a small rubber catheter that is inserted in the rectum and then inflated. That is very simple as compared to the optical method, which uses a 5 foot 7 inch flexible tube (endoscope) that is inserted into the rectum and pushed to or near the beginning of the large intestine.
A significant disadvantage of the older optical method is that it has a much higher risk of infection. The endoscopes that are inserted into the rectum must be extremely sterile to avoid the risk of infection. Unfortnately, in a recent small study 15% of the endoscopes failed to provide an acceptable level of sterilization. The risk is that a contaminated endoscope can transmit HIV, hepatitis B and C, and other blood-borne viruses to patients.
One advantage of an optical colonoscopy is the fact that the doctor can remove any polyp or suspicious tissue for a biopsy. Certainly this is an important advantage over the virtual version. However, statistics have shown that only about 6% of the patients receiving an optical colonoscopy required any tissue removal. Or stated another way, 94% of patients do not require any tissue removal.
However, if the doctor performing a virtual colonoscopy sees any suspicious tissue or larger polyps he/she will schedule an optical colonscopy for the patient so some of the tissue can be removed for study.