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[´ëÀå³»½Ã°æ »ðÀÔ¹ý] - ðû

ºñÀü¹®°¡ ÀÌÁØÇà °­ÀÇ (Àú´Â ÀÌ Ã¥À» º¸°í ´ëÀå³»½Ã°æÀ» ¹è¿ü½À´Ï´Ù. Cotten ´ëÀå³»½Ã°æ»ðÀÔ¹ý PDF ¾ÏÈ£ÀÖÀ½)

Àü¹®°¡ ¹éµ¿ÈÆ ±³¼ö´Ô °­ÀÇ. ´ëÇѼÒÈ­±â³»½Ã°æÇÐȸ VOD ¼­ºñ½º. Log-in ÇÊ¿ä

´ëÀå³»½Ã°æ »ðÀÔ¹ý. Á¶¿ø¿µ

2022-8-21 ³»½Ã°æ¼¼¹Ì³ª

´ëÀå³»½Ã°æ ¾È³»¹®. 2023³â °³Á¤ÆÇ. »ï¼º¼­¿ïº´¿ø ³»½Ã°æ½Ç

1. Box simulator¸¦ ÀÌ¿ëÇÑ ´ëÀå³»½Ã°æ »ðÀÔ¼ú ÈÆ·Ã

2. ´ëÀå³»½Ã°æ »ðÀÔÀÇ °³³ä

3. ±âº» ¼ú±â

4. Loop Ç®±â ¹× »óȲº° ´ëó¹ý

5. À§ º¯È­¿Í º¹ºÎ ¾Ð¹Ú

6. Blind area

7. Technical tips

8. ¾ÈÀüÇÑ ´ëÀå³»½Ã°æ°ú õ°ø µî ÇÕº´Áõ

9. FAQs

10. References

YouTube - Straight colon model and anatomic colon model

YouTube - How to set up CM-15 colon phantom (Olympus).

YouTube - Basic movement 1 (Olympus). How to hold the endoscope

YouTube - Basic movement 2 (Olympus). One to one movement in the descending colon & variable stiffness

YouTube - Exercise 1. Right turn shortening (Olympus)

YouTube - Exercise 2. Avoid sigmoid loop formation with the help of abdominal compression (Olympus)

YouTube - Exercise 3. Passing the sigmoid without loop formation and without abdominal compression (Olympus)

YouTube - Exercise 4. Shortening of the transverse colon (Olympus)

YouTube - Forbidden movements(Olympus)


1. Box simulator¸¦ ÀÌ¿ëÇÑ ´ëÀå³»½Ã°æ »ðÀÔ¼ú ÈÆ·Ã

À§³»½Ã°æ°ú ¸¶Âù°¡Áö°í ´ëÀå³»½Ã°æ¿¡¼­µµ »ðÀÔ¹ý ¹è¿ì±â¿¡¼­ simulator ÈÆ·ÃÀº ¸Å¿ì Áß¿äÇÕ´Ï´Ù. ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò¿¡¼­´Â Á¤±âÀûÀÎ Col-BOXIM workshopÀ» ¿î¿µÇÏ°í ÀÖ½À´Ï´Ù.

[2017-8-27] KSGE ³»½Ã°æ¼¼¹Ì³ª

2017-8-27. ³»½Ã°æÇÐȸ ¼¼¹Ì³ª ´ëÀå³»½Ã°æ»ðÀÔ¹ý simulator hands-on¿¡¼­´Â Kyoto Kogaku »ç modelÀÌ »ç¿ëµÇ¾ú½À´Ï´Ù. ¼³¸í µ¿¿µ»óÀ» Âü°íÇϽñ⠹ٶø´Ï´Ù. »ï¼º¼­¿ïº´¿ø¿¡¼­´Â ¾Æ·¡¿Í °°ÀÌ Kogen »ç modelÀ» »ç¿ëÇÏ°í ÀÖ½À´Ï´Ù. ¿À´Ã Á¦°¡ °üÂûÇÑ ¹Ù Kogen Á¦Ç°¿¡ ºñÇÏ¿© Kogaku Á¦Ç°Àº colonÀÌ Á¶±Ý ´õ ±æ°í loop°¡ Á» ´õ acute agulationÀ» Çü¼ºÇÏ´Â °æÇâÀÌ ÀÖ¾ú½À´Ï´Ù. Á÷Á¢ÀûÀÎ ºñ±³´Â ¾î·Æ½À´Ï´Ù¸¸, Kogen Á¦Ç°¿¡ ºñÇÏ¿© Kogaku Á¦Ç°ÀÌ Á¶±Ý ´õ ¾î·Á¿ï °Í °°¾Ò½À´Ï´Ù. Kogen Á¦Ç°À¸·Î ¸ÕÀú ¿¬½ÀÇÑ ÈÄ Kogaku Á¦Ç°À¸·Î ¿¬½ÀÇÏ¸é ´õ ÁÁ°Ú´Ù´Â »ý°¢À̾ú½À´Ï´Ù.

[2018³â 3¿ù 17ÀÏ] »ï¼º¼­¿ïº´¿ø ³»½Ã°æ½Ç ȸÀÇ½Ç ¹× ȸº¹½Ç

Åä¿äÀÏ ¿ÀÀü¿¡ ¼ÒÈ­±âºÐ°ú ³»°ú Àü°øÀÇ 4³âÂ÷ , ¼ÒÈ­±â³»°ú ÀÓ»ó°­»ç, ±×¸®°í ¸î ºÐÀÇ ¿Ü°ú ÀÓ»ó°­»ç ¼±»ý´ÔµéÀ» ¸ð½Ã°í ´ëÀå³»½Ã°æ »ðÀÔ¹ý ¿öÅ©¼óÀ» ÁøÇàÇÏ¿´½À´Ï´Ù. Àú¿Í ±èÅÂÁØ ±³¼ö´ÔÀÇ introductory lecture ÈÄ box simulator¸¦ ÀÌ¿ëÇÑ hands-on trainingÀÌ ÀÖ¾ú½À´Ï´Ù.

[2019³â 6¿ù 22ÀÏ]

À§³»½Ã°æ BOXIM (box simulator) trainingÀÌ Àß ÁøÇàµÇ°í ÀÖÀ¸¹Ç·Î ÀÌÁ¦´Â ´ëÀå³»½Ã°æ BOXIM workshopÀ» setupÇϱâ À§ÇÏ¿© ³ë·ÂÇÏ°í ÀÖ½À´Ï´Ù. Áö±Ý±îÁö º´¿ø ³»½Ã°æ½Ç ȸº¹½Ç¿¡¼­ ÁøÇàÇÏ¿´´ø ´ëÀå³»½Ã°æ BOXIM workshopÀ» ¿ÃÇØ´Â ÀÏ¿ø¿ª »ï¼º¼­¿ïº´¿ø ÀÓ»ó½Ã¹Ä·¹À̼Ǽ¾ÅÍ·Î ÀÚ¸®¸¦ ¿Å°Ü ÁøÇàÇÏ¿´½À´Ï´Ù (2019³â 6¿ù 22ÀÏ).

±èÅÂÁØ ±³¼ö´ÔÀÇ ¸ÚÁø °­ÀÇ¿Í demonstrationÀÌ ÀÖ¾ú½À´Ï´Ù. Àú´Â KSGE ³»½Ã°æ¼¼¹Ì³ª¿¡¼­ ÀÖ¾ú´ø ºÎ»êÀÇ´ë ¹éµ¿ÈÆ ±³¼ö´ÔÀÇ °¨µ¿ÀûÀÎ °­ÀǸ¦ ¼Ò°³Çß½À´Ï´Ù. ¹éµ¿ÈÆ ±³¼ö´ÔÀº ´ëÀå³»½Ã°æ »ðÀÔÀÇ ÆÐÅÏÈ­¸¦ ÁÖÀåÇϼ̴µ¥ ¸Å¿ì Áß¿äÇÑ °³³äÀ̶ó°í »ý°¢ÇÕ´Ï´Ù.

´ëÇѼÒÈ­±â³»½Ã°æÇÐȸ VOD ¼­ºñ½º. Log-in may be required.


2. ´ëÀå³»½Ã°æ »ðÀÔÀÇ °³³ä

´ëÀå³»½Ã°æ ½Ã Ç×¹®»ðÀÔºÎÅÍ ÁÖÀÇÇØ¾ß ÇÕ´Ï´Ù. ½Ç¼ö·Î vagina·Î »ðÀԵǴ ¿¹°¡ ÀÖ½À´Ï´Ù. Uterine cervixÀÔ´Ï´Ù. ½ÉÁö¾î´Â mass·Î »ý°¢ÇÏ°í Á¶Á÷°Ë»ç¸¦ ÇÏ¿© Á¤»ó uterine cervix epitheliumÀ̶ó´Â °á°ú¸¦ ¹Þ±âµµ ÇÕ´Ï´Ù.

´ëÇÑÀ忬±¸ÇÐȸ ºÎ¿ï°æÁöȸ¿¡¼­ ¹ß°£ÇÑ '´Ù¾çÇÑ ÇϺÎÀ§Àå°ü Áõ·Ê (2023)'¿¡¼­ ´ëÀå³»½Ã°æÀ» ¿ì¹ßÀûÀ¸·Î Áú³» »ðÀÔÇÏ¿© °ø±â°¡ Àڱðú ³­°üÀ» ÅëÇØ º¹°­³»·Î À̵¿ÇÏ¿© pneumoperitoneumÀÌ ¹ß»ýÇÏ¿´´ø Áõ·Ê¸¦ º¸¾Ò½À´Ï´Ù.

±âº» °³³äÀº ´ëÀå¿¡ ³»½Ã°æÀ» ¹Ð¾î ³Ö´Â °ÍÀÌ ¾Æ´Ï°í ¾ÆÄÚµð¾ðó·³ ´ëÀåÀ» Â÷°îÂ÷°î Á¢¾î°¡´Â °ÍÀÔ´Ï´Ù.

Retroperitoneum¿¡ °íÁ¤µÈ ºÎÀ§¿Í °íÁ¤µÇÁö ¾ÊÀº ºÎÀ§°¡ ÀÖ½À´Ï´Ù. Loop°¡ »ý±â´Â ¿øÀÎÀÔ´Ï´Ù.


[2021-4-26. Á¦37ȸ ´ëÇÑÀ§´ëÀå³»½Ã°æÇÐȸ Ãá°èÇмú´ëȸ Á¶¿ø¿µ ¼±»ý´Ô °­ÀÇ Summary]

¿Þ¼ÕÀº ¾÷´Ù¿î, ¿À¸¥¼ÕÀº Á¿ìÃàÀüȯ
±¸ºÐ µ¿ÀÛÀÇ ¿¬¼ÓÀÔ´Ï´Ù.
JÅÏÀº ±¸ºÒ°áÀå ¿Ü¿¡´Â °¡´ÉÇÏÁö¸¸ ¹«¸®Çؼ­ ÇÏÁö ¸¶¼¼¿ä.
´ëºÎºÐÀº ¿ìÃø¹æÇâ ÅäÅ©¸¦ Áָ鼭 hooking, push, pullÀÔ´Ï´Ù.
ÁøÇà ¹æÇâÀÇ °áÁ¤
Á÷ÀåÀº ÁÂ-¿ì-Á ¾Æ´Ï¸é ¿ì-ÁÂ-¿ì·Î Houston valve Åë°ú
RF-SF±îÁö´Â ÀϹÝÀûÀ¸·Î È­¸é ¿ì»óÃøÀ¸·Î ÁøÇà¹æÇâÀÌ µÇ¸é ½¬¿î ¹æÇâÀÔ´Ï´Ù.
ÁÂÃøÀ§ÁÖ³ª ÁÂ¿ì ¿À¶ô°¡¶ôÇÏ¸é ±â¼úÀ» ÀÌ¿ëÇØ ´ÜÃà°ú ÃàÀ¯Áö¸¦ ÇÕ´Ï´Ù.
¿ìÃø ÀåÁøÇàÀÌ ¿Ï¼ºµÇ¸é »ó´ëÀûÀ¸·Î ÁÂÃøÀº ½±½À´Ï´Ù.
ÀÏÀιýÀ̶ó°í ÇÏÁö¸¸
º¸Á¶ÀÚÀÇ µµ¿ò¿äûÀº ÀÚÁ¸½É ±ðÀÌ´Â °ÍÀÌ ¾Æ´Õ´Ï´Ù.
º¹ºÎ¾Ð¹Ú, ÀÚ¼¼º¯°æ, ¼±´ÜºÎ Àâ¾ÆÁÖ±â µî µµ¿ÍÁÖ¸é ½¬¿öÁý´Ï´Ù.
³»½Ã°æ³»¿¡ °æ¼º Á¶Á¤ÀåÄ¡°¡ ³»ÀåµÇ¾î ÀÖÀ¸´Ï »ç¿ëÇϼ¼¿ä.


3. ±âº» ¼ú±â

Àú´Â ÀÌ Ã¥À» º¸°í ´ëÀå³»½Ã°æÀ» ¹è¿ü½À´Ï´Ù. Cotten ´ëÀå³»½Ã°æ»ðÀÔ¹ý PDF ¾ÏÈ£ÀÖÀ½

±âº» ¼ú±â 1. Distal tip rotation.

±âº» ¼ú±â 2. °ø±âÀÇ ÈíÀÔ

±âº» ¼ú±â 3. Ski ŸµíÀÌ

±âº» ¼ú±â 4. Jiggling

±âº» ¼ú±â 5. Compression

±âº» ¼ú±â 6. ÀÚ¼¼ º¯È¯

±âº» ¼ú±â¸¦ ÅëÇÏ¿© Àß »ðÀÔµÇ¸é ³»½Ã°æ Á¶ÀÛÀÇ ÀúÇ×°¨ÀÌ ¾ø¾î¾ß ÇÕ´Ï´Ù. Á¶±Ý ¹Ð¸é µé¾î°¡°í Á¶±Ý ´ç±â¸é ºüÁö´Â »óÅ°¡ ÁÁ½À´Ï´Ù. Scope°¡ ¸¶Ä¡ ¸·´ëó·³ »¥»¥ÇÑ Á÷¼±À¸·Î ´À²¸Áö¸é ¿Ïº®ÇÕ´Ï´Ù.

´ëÀå³»½Ã°æ¿¡¼­ ²ªÀÎ °÷À» Åë°úÇÏ´Ùº¸¸é ¾à°£ÀÇ Á¡¸·ÃâÇ÷ÀÌ ¹ß»ýÇÒ ¼ö ÀÖ½À´Ï´Ù.


4. Loop Ç®±â ¹× »óȲº° ´ëó¹ý

Loop¸¦ Ǫ´Â °¡Àå ±âº»ÀûÀÎ ¹æ¹ýÀº ¿ìȸÀü´ÜÃà¼ú(right turn shortenin)ÀÔ´Ï´Ù. Alpha loop¸¦ Ǫ´Â ¹æ¹ýÀÔ´Ï´Ù. reverse-alpha loopµµ °°Àº ¹æ½ÄÀ¸·Î Ç® ¼ö ÀÖ½À´Ï´Ù.

Withdrawal in T colon

Hooking

Air suction in A colon

Stiffness¸¦ Á¶Á¤Çغ»´Ù.


5. üÀ§ º¯È­¿Í º¹ºÎ ¾Ð¹Ú

2017³â 12¿ù Á¦°¡ ´ëÀå³»½Ã°æ °Ë»ç¸¦ ¹Þ¾Ò½À´Ï´Ù (50¼¼ ±â³ä?). ÁøÁ¤ ³»½Ã°æÀÌ ¾Æ´Ï¾úÀ¸¹Ç·Î ¸ðµç °úÁ¤À» »ý»ýÈ÷ ´À³¥ ¼ö ÀÖ¾ú½À´Ï´Ù. D colon¿¡¼­ splenic flexure¸¦ ³Ñ¾î°¡±â Àü supineÀ¸·Î ÀÚ¼¼¸¦ ¹Ù²Ù¾ú½À´Ï´Ù. Àß ³Ñ¾î°¡Áö ¾Ê´Â ºÎÀ§°¡ ÀÖ¾ú´ø °Íµµ ¾Æ´Ï°í, ¸î ¹øÀÇ ½Ãµµ¸¦ Çß´ø °Íµµ ¾Æ´Ï°í, º°·Î ¾ÆÇÁÁöµµ ¾Ê¾Ò´Âµ¥ ½Ã¼úÇØÁֽŠ¼±»ý´Ô²²¼­´Â D colon¿¡¼­ ±×³É supineÀ¸·Î ÀÚ¼¼¸¦ ¹Ù²Ùµµ·Ï Áö½ÃÇϼ̽À´Ï´Ù. °Ë»ç´Â ¹«³­È÷ ³¡³µ½À´Ï´Ù. °ú°Å¿¡´Â ¸î ¹ø ½ÃµµÇغ¸°í Àß ³Ñ¾î°¡Áö ¾Ê´Â ºÎÀ§°¡ ÀÖÀ¸¸é ÀÚ¼¼¸¦ ¹Ù²Ù¾úÁö¸¸, ÃÖ±Ù¿¡´Â ÀûÀýÇÑ ½ÃÁ¡¿¡ ¹Ì¸® supineÀ¸·Î ÀÚ¼¼¸¦ º¯°æÇÔÀ¸·Î½á ÈξÀ ºü¸£°í ´ú ¾ÆÇÁ°Ô °Ë»çÇÒ ¼ö ÀÖ´Ù°í ÇÕ´Ï´Ù.

»ç½Ç ¼Óµµ¿Í ÅëÁõ¸¸ÀÌ ¾Æ´Õ´Ï´Ù. ÀûÀýÇÑ Ã¼À§ º¯È­·Î ³»½Ã°æ »ðÀÔ ½Ã°£À» ´ÜÃà½ÃÅ°°í ¼±Á¾ ¹ß°ßÀ²À» ³ôÀÏ ¼ö ÀÖ´Ù°í ÇÕ´Ï´Ù.

ÀÚ·á: ±èÅÂÁØ ±³¼ö´Ô

ÀÚ·á: ±èÅÂÁØ ±³¼ö´Ô

* Âü°íÀÚ·á: ¿¹º´´ö. üÀ§ º¯È¯°ú º¹ºÎ ¾Ð¹Ú (³»½Ã°æÇÐȸ ¼¼¹Ì³ª)


6. Blind area in colonoscopy


7. Technical tips

¹°ÀÌ °íÀÎ À§Ä¡¸¦ Âü°íÇÏ¿© º´¼ÒÀÇ ¹æÇâÀ» ÁüÀÛÇÒ ¼ö ÀÖ½À´Ï´Ù.

2018³â À§´ëÀå³»½Ã°æÇÐȸ ¿ÀÅÂÈÆ ¼±»ý´Ô °­ÀÇ·Ï¿¡¼­


8. ¾ÈÀüÇÑ ´ëÀå³»½Ã°æ°ú õ°ø µî ÇÕº´Áõ

´ëÀå³»½Ã°æ °Ë»çÀÇ ¾ÈÀü¿¡ ´ëÇÏ¿© Cotton and William's Practical Gastrointestinal Endoscopy (7ÆÇ, 82ÂÊ)¿¡´Â ´ëÀå³»½Ã°æ ¾ÈÀü¿¡ ´ëÇÏ¿© ¾Æ·¡¿Í °°ÀÌ ¾ð±ÞµÇ¾î ÀÖ½À´Ï´Ù. Áö³ªÄ£ ÁøÁ¤ÀÌ À§ÇèÇÒ ¼ö ÀÖÀ½À» °­Á¶ÇÏ°í ÀÖ½À´Ï´Ù.

"Safety during colonoscopy comes from gentle technique and avoiding pain (or oversedation, which masks the pain response as well as contributing pharmacological hazards). Before starting a colonoscopy it is impossible to know if there are adhesions, whether the bowel is easily distensible, and whether its mesenteries are free-floating or fixed; pain is the only warning that the bowel or its attachments are being unreasonably strained. The endoscopist must repect any protest from the patient; a mild groan in a sedated patient may be equivalent to a scream of pain without sedation. Moreover, it is hazardous to give repeated doses of sedatives intravenously, effectively anesthetizing the patient without an anesthetist being present. It is safer in such cases to abandon the procedure and reschedule as a formal anesthetic procedure. Total colonoscopy is not always technically possible, even for experts."

2019³â 12¿ù 26ÀÏ ¸ñ¿äÁ¡½ÉÁý´ãȸ¿¡¼­ ÀÓ»ó°­»ç ¿ÀÁø¸í ¼±»ý´Ô²²¼­ ÃÖ±Ù ¸®ºä¸¦ Àß Á¤¸®ÇØ Áּ̽À´Ï´Ù. ¸ÞŸºÐ¼®¿¡¼­ 1000 °Ë»ç ´ç õ°øÀº 0.58°Ç, ÃâÇ÷Àº 2.4°Ç, »ç¸ÁÀº 0.03°ÇÀ̾ú½À´Ï´Ù. 1000¸í °Ë»ç¿¡¼­ 3¸íÀÇ Áß¿ä ÇÕº´ÁõÀÌ ¹ß°ßÇÏ¿´´Ù´Â °ÍÀÔ´Ï´Ù. ƯÈ÷ »ç¸ÁÀº 115,2158 °Ë»ç¿¡¼­ 36°ÇÀÌ ¹ß»ýÇÏ¿´½À´Ï´Ù. 100¸¸¸í °Ë»çÇϸé 31¸íÀÌ »ç¸ÁÇÑ´Ù´Â Åë°èÀ̹ǷΠÀü±¹¹Î ´ë»ó °ËÁø ´ëÀå³»½Ã°æÀÇ À§Ç輺À» ¿¹ÃøÇÒ ¼ö ÀÖÁö ¾ÊÀ»±î »ý°¢µË´Ï´Ù.


[õ°øÀÇ ¹ß»ý ±âÀü°ú ¿øÀÎ]

Peritoneal seedingÀ» µ¿¹ÝÇÑ metastatic ovarian cancer¿¡¼­ ¹ß»ýÇÑ ´ëÀå³»½Ã°æ õ°ø. ³Ê¹« ¾î·Á¿î ȯÀÚ, ²À ´ëÀå³»½Ã°æÀÌ ÇÊ¿äÇÏÁö ¾ÊÀº ȯÀÚ¿¡¼­´Â °Ë»ç ÀÚü¸¦ ÇÇÇÏ´Â °Íµµ ¹æ¹ýÀÔ´Ï´Ù.

´ëÀå³»½Ã°æ »ðÀÔ µµÁß °Ô½Ç(ƯÈ÷ S-colon diverticulum)°ú ´ëÀå lumenÀ» ±¸ºÐÇÏÁö ¸øÇÏ°í °­ÇÏ°Ô ¹Ð¾î³ÖÀ¸¸é õ°øÀÌ ¹ß»ýÇÒ ¼ö ÀÖ½À´Ï´Ù.

S-colon¿¡ ¸¹Àº °Ô½ÇÀÌ ÀÖ´ø Áõ·ÊÀÔ´Ï´Ù. S-colon ¿µ¿ª¿¡ ±¸½½°ú °°Àº ´ëº¯ÀÌ ÀÖ¾ú´Âµ¥ ÀϺδ lumen¿¡¼­ ±¸¸£°í ÀÖ¾ú°í ÀϺδ S-colon¿¡ ¹ÚÇô ÀÖ¾ú½À´Ï´Ù. Diverticular opening°ú ´ëº¯¶§¹®¿¡ ´ëÀå lumenÀ» ±¸ºÐÇϱⰡ ½±Áö ¾Ê¾Ò½À´Ï´Ù. Á¶½ÉÁ¶½É lumenÀ» ã°í blindÇÏ°Ô ¹ÐÁö ¾Ê´Â ¼ö ¹Û¿¡ ¾ø½À´Ï´Ù.


[õ°ø ¿¹¹æ tip]

1) ÃàÀ¯Áö ´ÜÃà¹ýÀÇ ÀǹÌÀ» ¼÷ÁöÇÑ´Ù.

2) ¹Ð¾î³ÖÀ» ¶§ Çã¿ëµÉ ¼ö ÀÖ´Â ÀúÇ×ÀÇ ÇѰ踦 üµæÇÏ°í ÀÖ¾î¾ß ÇÑ´Ù.

3) Midazolam À» »ç¿ëÇÏÁö ¾ÊÀº Æò±ÕÀûÀΠȯÀÚ°¡ ¾ÆÇÁ´Ù°í ÇÏ´Â ¼öÁØÀ» ³Ñ¾î¼­¼­´Â ¾È µÈ´Ù.

4) ȯÀÚ°¡ ºñ¸íÀ» Áö¸£´Â ¼öÁØÀ̸é ȯÀÚ¸¦ ¾ß´ÜÄ¡Áö ¸»°í, ½Ã¼úÀÚÀÇ techniqueÀ» µÚµ¹¾Æ º¸¾Æ¾ß ÇÑ´Ù.

5) ´ëºÎºÐÀÇ Ãµ°øÀº Á÷Àå°ú S»ó°áÀå¿¡¼­ ¹ß»ýÇϹǷΠÀÌ ºÎºÐÀ» Åë°úÇϴµ¥ ´õ¿í ÁÖÀǸ¦ ±â¿ïÀδÙ.

6) Á÷Àå¿¡¼­ J turn ½Ã õ°øµÇ´Â °æ¿ì°¡ Á¾Á¾ ÀÖÀ¸¹Ç·Î ¹æ¹ýÀ» ¼÷ÁöÇÏ°í ÁÖÀǸ¦ ¿äÇÑ´Ù.

7) ´ëÀåÀÇ Á¤È®ÇÑ ÁÖÇà¹æÇâÀ» ¿¹ÃøÇÒ ¼ö ¾ø´Â °æ¿ì¿¡´Â blind·Î ¹Ð¾î ³ÖÁö ¾Ê´Â´Ù.

8) °Ô½ÇÀÌ ¸¹Àº ȯÀÚÀÇ °æ¿ì ÁÖÀǸ¦ ¿äÇϸç ÀÔ±¸°¡ ³ÐÀº °Ô½ÇÀ» true lumenÀ¸·Î ¿ÀÀÎÇÏÁö ¾Ê´Â´Ù.

9) »êºÎÀΰú ¼ö¼úÀ» ¹ÞÀº °æ¿ì À¯ÂøÀ¸·Î »ðÀÔÀÌ ¾î·Á¿ì¹Ç·Î ºÎµå·´°Ô ÁÖÀÇÇÏ¸ç »ðÀÔÇÑ´Ù.

10) ¾î·Á¿î À§Ä¡¿¡ ÀÖ´Â ÀÛÀº ¿ëÁ¾À» Á¦°ÅÇϱâ À§ÇÏ¿© Áö³ªÄ£ ³»½Ã°æ Á¶ÀÛÀ» ÇÇÇÑ´Ù.

11) 2³âÂ÷ ÀÓ»ó°­»ç¿Í ½ºÅǵéÀº Áö¼ÓÀûÀ¸·Î ÀÏ´ëÀÏ ±³À°À» ÅëÇÏ¿© »ðÀÔ¹ý°ú ÁÖÀÇ »çÇ× ±³À° Ưº°ÇÑ ½ºÄÉÁìÀÌ ¾ø´Â ÀÓ»ó°­»çµéÀº ½ºÅÇ ´ëÀå ³»½Ã°æÀ» Æ´Æ´ÀÌ Âü°üÇϸ鼭 Áú¹®ÇÑ´Ù.

12) ÀÓ»ó°­»çµéÀº ³»½Ã°æ »ðÀÔ ½Ã ¹«¸®ÇÏÁö ¾ÊÀ¸¸ç »ðÀÔÀÌ ¾î·Á¿î °æ¿ì À­³âÂ÷³ª ½ºÅÇ¿¡°Ô consultÇÏ´Â °ÍÀ» ¾î·Á¿öÇÏÁö ¾Ê´Â´Ù.

13) 15ºÐ³»¿¡ SD junctionÀ» Åë°úÇÏÁö ¸øÇÑ °æ¿ì ´Ù¸¥ ÀÇ·áÁø¿¡°Ô consult ÇÑ´Ù. ÀÌ 15ºÐ°£ÀÇ ³ë·Â Áß¿¡µµ ¹«¸®ÇÑ ÈûÀ» °¡Çؼ­´Â ¾ÈµÈ´Ù.

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15) ¼ÕÀ» ¹Ù²Û ÈÄ¿¡µµ 15ºÐ ÀÌ»ó »ðÀÔÀÌ ¾î·Á¿ì¸é ȯÀÚ¿¡°Ô ¼³¸íÇÑ ÈÄ Áß´ÜÇÑ´Ù. ÇâÈÄ CT colonography, ¶Ç´Â Barium enema ó¹æÇÒ ¼ö ÀÖ´Ù.

16) 2³âÂ÷ ÀüÀÓÀǵéÀ̳ª ½ºÅǵéÀº ¾î·Á¿î ³»½Ã°æ¿¡ ´ëÇÑ consult¿¡ ´ëÇØ Àû±ØÀûÀ¸·Î µµ¿òÀ» ÁØ´Ù.

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* Âü°í: EndoTODAY Áø´Ü ´ëÀå ³»½Ã°æ õ°ø


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[2021-8-14. ¾Öµ¶ÀÚ Áú¹®] ´ëÀå³»½Ã°æ ÈÄ ¹ß»ýÇÑ Ãæ¼öµ¹±â¿° Acute appendicitis after colonoscopy

±³¼ö´Ô. ¾È³çÇϽʴϱî. Áö¹æ °ÇÁø¼¾ÅÍ¿¡¼­ ÀÏÇÏ°í ÀÖ´Â XXXÀ̶ó°í ÇÕ´Ï´Ù. ƯÀÌÇÑ(?) °æÇèÀ» Çؼ­ ¸ÞÀÏÀ» µå·Á º¾´Ï´Ù.

´ç´¢·Î Åõ¾àÇÏ´Â 60´ë ¿©È¯À̽ðí ÀÌÀü¿¡µµ ¿©·¯ Â÷·Ê ´ëÀå ³»½Ã°æÀ» ¹ÞÀ¸½Å ºÐÀ̾ú½À´Ï´Ù. À̹ø °Ë»ç¿¡¼­´Â ¿ëÁ¾ÀÌ 3°³ ÀÖ¾ú°í 2°³´Â °âÀÚ·Î Á¦°Å ÇÏ¿´°í ³ª¸ÓÁö 1°³´Â prox. A-colon¿¡¼­ cold snare polypectomy·Î Á¦°Å ÇÏ¿´½À´Ï´Ù.

ȯÀÚ´Â °Ë»ç ÈÄ ºÒÆí°¨ ¾øÀÌ ±Í°¡ ÇÏ¿´´Ù°¡ ´ÙÀ½ ³¯ º¹ÅëÀ» È£¼ÒÇϸç Àç³»¿ø ÇÏ¿´°í 37.6ÀÇ ¹ß¿­¿¡ ¿ìÇϺ¹ºÎ·Î ¾ÐÅëÀÌ ÇöÀúÇÑ ¾ç»óÀ̾ú½À´Ï´Ù. labÀº CBC 5,140(43.5%)-12.0/34.1-156k, CRP 0.02¿¡¼­ CBC 9,740(72.8%)-11.3/32.2-139k, CRP 0.94À¸·Î º¯È­ ÇÏ¿´½À´Ï´Ù. Polypectomy ºÎÀ§°¡ Rt. colonÀ̾ Ȥ½Ã õ°øÀÌ ¾Æ´Ò±î °ÆÁ¤À» Çߴµ¥ CXR¿¡¼­ free air´Â ¾ø¾ú°í A-P CT¿¡¼­ appendicitis·Î È®ÀÎ µÇ¾î ¼ö¼ú ÀÇ·Ú ÇÏ¿´½À´Ï´Ù.

Àú´Â Áö±Ý±îÁö ¾ËÁö ¸ø ÇßÁö¸¸ ´ëÀå ³»½Ã°æ ÈÄ Ãæ¼öµ¹±â¿°ÀÌ ¹ß»ýÇÑ °æ¿ì°¡ ¾øÁö´Â ¾Ê´õ±º¿ä. Cecum, appendiceal orifice ÁÖÀ§¿¡¼­ Ưº°ÇÑ Á¶ÀÛÀ» ÇÑ °Í °°Áö´Â ¾ÊÀºµ¥ ¾î¶² °Í ¶§¹®¿¡ ÀÌ·± ¹®Á¦°¡ ¹ß»ýÇÏ¿´´ÂÁö Á¦°¡ ³õÄ¡°í ÀÖ¾ú°Å³ª ÁÖÀÇÇØ¾ß ÇÒ »çÇ×ÀÌ ÀÖ´Â °ÍÀÎÁö ±³¼ö´ÔÀÇ ÀÇ°ßÀ» ±¸ÇØ º¾´Ï´Ù.

[2021-8-15. ÀÌÁØÇà ´äº¯]

¾È³çÇϽʴϱî. ÁÁÀº Áú¹® °¨»çÇÕ´Ï´Ù.

´ëÀå³»½Ã°æ ÈÄ Ãæ¼öµ¹±â¿°Àº µå¹°Áö¸¸ Àß ¾Ë·ÁÁø ÇÕº´ÁõÀÔ´Ï´Ù. Àú´Â °æÇèÇÏÁö ¸øÇßÁö¸¸ 2007³â °¡Å縯´ëÇб³¿¡¼­ ÀüÇüÀûÀÎ Áõ·Êº¸°í¸¦ ÇÏ¿´´Âµ¥ (Korean J Intern Med 2007), discussionÀÌ ¾ÆÁÖ Ãæ½ÇÇÏ°Ô Àß ¾²¿© ÀÖ½À´Ï´Ù. ÀϺθ¦ ¿Å±é´Ï´Ù.

The incidence of appendicitis following colonoscopy was about 0.038%. This is lower than the incidence of bleeding (0.21%), colonic perforation (0.1%) or abdominal pain (0.09%).

The suggested mechanisms of appendicitis after colonoscopy are 1) pre-existing subclinical disease of the appendix, 2) elevation of the intraluminal pressure with insufflated air can obstruct the luminal orifice by lengthening the appendix, 3) elevated intraluminal pressure can force bowel contents, and especially fecaliths, into the appendix, 4) direct intubation of the colonoscope into the appendiceal lumen can induce inflammation and 5) mucosal injury around the appendiceal orifice can cause local edema and obstruction of the appendiceal lumen.

¹ß»ý±âÀüÀ» »ý°¢ÇÏ¸é ¿¹¹æ¹ýÀº °ÅÀÇ ¾ø´Â °Í °°½À´Ï´Ù. °ø±â¸¦ Àû°Ô ³Ö°í ªÀº ½Ã°£ °Ë»ç¸¦ Çϸé adenoma detection rate°¡ ¶³¾îÁö´Â ¹®Á¦°¡ ÀÖ°í... ´Ù¸¥ °ÍÀ» »ý°¢Çغ¸´õ¶óµµ µüÈ÷ ¹æ¹ýÀÌ ¾ø½À´Ï´Ù. 'GentleÇÏ°í È¿À²ÀûÀÎ ³»½Ã°æ ¼ú±â'¶ó´Â ¾Ö¸ÅÇÑ Ç¥Çö¹Û¿¡ µå¸± ¸»¾¸ÀÌ ¾ø½À´Ï´Ù.

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[2021-2-11. YouTube Áú¹®]

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[2021-3-29. ±èÀº¶õ ±³¼ö´Ô ´äº¯]

D colon¿¡¼­ loop¸¦ ¸ðµÎ Ǭ »óÅ¿¡¼­ cecal intrubation¿¡ ¾î·Á¿òÀ» ´À³¢´Â °æ¿ì´Â ´ÙÀ½°ú °°Àº °æ¿ìµéÀÌ ÀÖ°Ú½À´Ï´Ù.

1) S colon loop°¡ Áö¼ÓÀûÀ¸·Î ¹ß»ýÇÏ´Â °æ¿ì: S colon loop°¡ ½ÉÇÏ°Ô »ý±â´Â ºÐµéÀÌ Àִµ¥, ÀÌÈÄ »ðÀԽÿ¡µµ Áö¼ÓÀûÀ¸·Î ¹®Á¦¸¦ À¯¹ßÇÒ ¼ö Àֱ⠶§¹®¿¡ D colon¿¡¼­ loop¸¦ Ç®°í Á÷¼±È­ ½ÃŲ ÀÌÈÄ¿¡µµ S colon ºÎÀ§ÀÇ º¹ºÎ ¾Ð¹ÚÀ» Áö¼ÓÇÑ »óÅ¿¡¼­ cecal intubationÀ» ½ÃµµÇÏ´Â °ÍÀÌ ÁÁ½À´Ï´Ù.

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³»½Ã°æ ÁøÀԽà loop°¡ Áö´Â °Íó·³ ³»½Ã°æÀº ª¾ÆÁö´Âµ¥, ´õ ÀÌ»ó ÁøÀÔµµ ¾ÈµÇ°í, º¹ºÎ ¾Ð¹ÚÀ» ¿©±âÀú±âÇصµ ÁøÀÔÀÌ ¾ÈµÇ´Â °æ¿ì°¡ Àִµ¥, ¹è°¡ Å©½Ã¸é¼­ ´Ã¾îÁö´Â ÀåÀ» °¡Áö½Å ºÐµéÀÌ ±×·¸½À´Ï´Ù. ³»½Ã°æÀ» push and pull back Çغ¸¸é¼­ ¼ÕÀ¸·Î loop°¡ ¸¸Á®Áö´Â ºÎÀ§¸¦ È®ÀÎÇØ º» ÈÄ loop°¡ ¸¸Á®Áö¸é pull backÇؼ­ loop¸¦ Ç®°í ±× ºÎÀ§¸¦ º¹ºÎ ¾Ð¹ÚÇÑ ÈÄ ÁøÀÔÀ» ½ÃµµÇØ º¸½Ã°í, ÀüÇô loop°¡ ¸¸Á®ÁöÁö ¾Ê´Â´Ù¸é pull backÇؼ­ loop ¸¦ Ǭ ÈÄ, º¹ºÎ¸¦ Àü¹ÝÀûÀ¸·Î ¸ðÀ¸´Â ¹æ¹ýÀ¸·Î º¹ºÎ ¾Ð¹ÚÀ» Çϵµ·Ï ÇÏ°í ´Ù½Ã ÁøÀÔÀ» ½ÃµµÇØ º¼ ¼ö ÀÖ°Ú½À´Ï´Ù.

[2021-3-30. ÀÌÁØÇà comment]

ÁÁÀº Áú¹®°ú ±èÀº¶õ ±³¼ö´ÔÀÇ Ãæ½ÇÇÑ ´äº¯¿¡ °¨»çÇÕ´Ï´Ù. ´ëÀå³»½Ã°æ »ðÀÔ¹ý °ü·ÃÇÏ¿© ¹éµ¿ÈÆ ±³¼ö´Ô °­ÀǸ¦ ÃßõÇÕ´Ï´Ù. KSGE ³»½Ã°æÇÐȸÀÇ µ¿¿µ»ó ¸µÅ©ÀÔ´Ï´Ù (log-in ÇÊ¿ä).

Àü¹®°¡ ¹éµ¿ÈÆ ±³¼ö´Ô °­ÀÇ. ´ëÇѼÒÈ­±â³»½Ã°æÇÐȸ VOD ¼­ºñ½º. Log-in ÇÊ¿ä

[2022-4-2. ÀÌÁØÇà]

Áö³­ hands-on training¿¡ Âü¼®ÇÏÁö ¸øÇÑ µÎ ºÐÀ» À§ÇÑ special Col-BOXIMÀ» ÁøÇàÇÏ¿´½À´Ï´Ù. ´Ü ÇÑ ¸íÀÌ¶óµµ hands-on training ¾øÀÌ ³»½Ã°æÀ» ½ÃÀÛÇÏ´Â ÀÏÀÌ ¾ø¾î¾ß ÇÑ´Ù´Â °ÍÀÌ Á¦ ½Å³äÀÔ´Ï´Ù.

2022-4-2. Colonoscopy BOXIM for 1st year fellows.

ÈÆ·Ã ÈÄ¿¡´Â ÀÌ·¸°Ô °ü¸®µË´Ï´Ù.


[2022-4-30. Á¦10ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª ÀÌÁØÇà Áú¹®]

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ÀÚ¼¼¿¡ ´ëÇÏ¿© ±â·ÏÀ» ³²±âÁö ¾ÊÁö¸¸ »ðÀÔÀÌ ¾î·Á¿ö ½Ã°£ÀÌ ¿À·¡ °É¸° °æ¿ì´Â ±× ³»¿ëÀ» ³²°Ü³õ±âµµ ÇÕ´Ï´Ù.


[2022-6-9. ¾Öµ¶ÀÚ Áú¹®]

Ç×»ó ÁÁÀº ³»¿ëÀ» Àß º¸°í ÀÖ½À´Ï´Ù. ¿¹Àü¿¡ »ý°å´ø Àǹ®Á¡Àε¥, °Ç°­°ËÁø ´ëÀå³»½Ã°æ ½ÃÇà ½Ã X-ray simple abdomen 2ÀåÀ» ¸ÕÀú Âï¾î¼­ ȯÀÚÀÇ Á÷Àå~¸ÍÀå±îÁöÀÇ ±æÀ» ¾î´À Á¤µµ orientation Àâ¾Æ³õ°í ´ëÀå³»½Ã°æÀ» ½ÃÇàÇÏ¸é µµ¿òÀÌ µÇÁö ¾ÊÀ»±î »ý°¢µË´Ï´Ù. Á¦°¡ x-ray Æǵ¶ ¹«·á ÇÁ·Î±×·¥À» »ç¿ëÇغ¸´Ï±î chestÀÇ °æ¿ì º´º¯À» ½±°Ô ã´Â °Í°°½À´Ï´Ù. ¸¸¾à simple abdomen µµ Á÷Àå~¸ÍÀå±îÁöÀÇ ÁÖÇà¹æÇâÀ̶ó´ø°¡, °Ô½ÇÀÇ À¯¹«, ÀåÁ¤°áÀÇ À¯¹«, ¿¹Àü ¼ö¼ú À¯Âø¿©ºÎ µîÀ» detection Çؼ­ ´ëÀå³»½Ã°æ ½ÃÇàÀü Àǻ翡°Ô Á¤º¸¸¦ ÁÙ ¼ö ÀÖ´Â Æǵ¶ÇÁ·Î±×·¥ÀÌ ÀÖ´Ù¸é õ°øµµ ÁÙÀÏ ¼ö ÀÖ°í, ´ëÀå³»½Ã°æ ¼öÇà½Ã°£µµ ´õ ´ÜÃàµÉ ¼ö ÀÖÁö ¾ÊÀ»±î¿ä?

¾îÂ÷ÇÇ °Ç°­°ËÁøÇÒ¶§ ´ëÀå³»½Ã°æ¹Þ´Â ºÐµéÀº chest ´Â ±âº»À¸·Î ÇÔ²² ½ÃÇà¹Þ´Âµ¥, °Å±â¿¡ simple abdomen erect/supine Ãß°¡ÇÑ´Ù°í Çؼ­ ½Ã°£ÀÌ ´õ °É¸®´Â °Íµµ ¾Æ´Ï°í, Çѱ¹Àº ÀÇ·áºñµµ Àú·ÅÇϴϱî Å©°Ô ºñ¿ëÀÌ ´õ ¸¹ÀÌ ¹ß»ýÇÏ´Â °ÍÀº ¾Æ´Ï¶ó°í »ý°¢ÇÕ´Ï´Ù. ±×¸®°í ´ëÀå³»½Ã°æÀÇ ÀûÇÕµµ¸¦ ÆǺ°ÇØÁÖ´Â simple abdomen x-ray Æǵ¶ ÇÁ·Î±×·¥µµ ÇöÀç ±â¼ú·Î ÃæºÐÈ÷ °¡´ÉÇϸ®¶ó°í »ý°¢µÇ´Âµ¥¿ä, Ȥ½Ã ±×°É ½ÃÇàÇÏ°í ÀÖ´Â °÷ÀÌ ÀÖ´ÂÁö¿ä? ¾Æ´Ï¸é, ´ëÀå³»½Ã°æ ½ÃÇàÀü simple abdomen À» ½ÃÇàÇϴ°ÍÀÌ Á¦ »ý°¢Ã³·³ Å©°Ô È¿°úÀûÀΰÍÀº ¾Æ´Ò·±Áö¿ä? ¼÷·ÃµÈ ´ëÀå³»½Ã°æ ÀÇ»ç¶ó¸é ±»ÀÌ simple abdomen ±îÁö ÇÊ¿ä¾øÀ» ¼öµµ ÀÖ°ÚÁö¸¸, ÄÉÀ̽º°¡ ¸¹Áö ¾ÊÀº ´ëÀå³»½Ã°æ ÀÇ»çÇÑÅ״ ȯÀÚ º¹ºÎ¿¡ ´ëÇÑ ¿µ»óÀÇÇÐÀû Á¤º¸°¡ µµ¿òÀÌ µÇÁö ¾Ê°Ú½À´Ï±î?

[2022-6-9. ¾Öµ¶ÀÚ Áú¹®]

ÁÁÀº Áú¹® °¨»çÇÕ´Ï´Ù. Àúµµ °æÇèÀÌ ¸¹Áö ¾ÊÁö¸¸ ÀÏ´Ü ÀÇ°ßÀ» µå¸³´Ï´Ù.

"x-ray Æǵ¶ ¹«·á ÇÁ·Î±×·¥À» »ç¿ëÇغ¸´Ï±î chestÀÇ °æ¿ì º´º¯À» ½±°Ô ã´Â °Í °°"´Ù´Â ³»¿ëÀº ÂüÀ¸·Î °í¹«ÀûÀÔ´Ï´Ù. ±â¼úÀÇ ¹ßÀüÀÌ ÀǷḦ µ½´Â´Ù´Â Á¡¿¡¼­ Àúµµ °ü½ÉÀÌ ¸¹½À´Ï´Ù.

´ëÀå³»½Ã°æ Àü º¹ºÎ CT°¡ ÀÖ¾î ÀåÀÇ °æ·Î¸¦ ´ëÃæ ÆľÇÇÒ ¼ö Àִ ȯÀÚ°¡ ÀÖ±â´Â Çѵ¥, ½ÇÁ¦ÀûÀ¸·Î ´ëÀå³»½Ã°æ °Ë»çÀÇ »çÀü °èȹÀ̳ª ½Ã°£ ´ÜÃàÀ̳ª ÇÕº´Áõ ¹ß»ý·ü °¨¼Ò¿¡ µµ¿òÀÌ µÈ´Ù´Â ±Ù°Å´Â ºÎÁ·ÇÑ °Í °°½À´Ï´Ù. ¿¬±¸ÇØ º¼ ¼ö ÀÖ´Â topicÀ̶ó°í´Â »ý°¢µÇÁö¸¸ ´çÀå °ËÁø¿¡¼­ ´ëÀå³»½Ã°æ Àü º¹ºÎ X-ray¸¦ Ãß°¡ÇÏ´Â °ÍÀº À̸£Áö ¾Ê³ª ½Í½À´Ï´Ù. Å« ÇØ´Â ¾Æ´ÒÁö ¸ô¶óµµ ¾à°£ÀÇ radiation hazardµµ °í·ÁÇÏÁö ¾ÊÀ» ¼ö ¾ø½À´Ï´Ù.

ÁÁÀº ¾ÆÀ̵ð¾î °¨»çÇÕ´Ï´Ù.

[2022-8-24. Webseminar Áú¹®]

CO2¸¦ ´ëÀå ³»½Ã°æ ÇÒ ¶§ ´ëÇк´¿ø¿¡¼­ ¸¹ÀÌ »ç¿ëÇϽôÂÁö¿ä?

[2022-8-29. ÀÌÁØÇà ´äº¯]

Àú´Â ¸ðµç ´ëÀå³»½Ã°æ¿¡¼­ CO2¸¦ »ç¿ëÇÏ´Â °ÍÀÌ ÁÁ°Ú´Ù°í »ý°¢ÇÕ´Ï´Ù. ±×·¯³ª ¾ÆÁ÷ ³»½Ã°æ °Ë»ç½Ç¸¶´Ù CO2°¡ ÁغñµÇ¾î ÀÖÁö ¾Ê¾Æ¼­ Ä¡·á³»½Ã°æ Áß½ÉÀ¸·Î »ç¿ëÇÏ°í ÀÖ½À´Ï´Ù. ÇöÀç »ï¼º¼­¿ïº´¿ø ³»½Ã°æÀ» ¸®³ëº£À̼ÇÀ» ¿¹Á¤ÇÏ°í ÀÖ½À´Ï´Ù. »õ ³»½Ã°æ½Ç¿¡¼­´Â ¸ðµç ¹æ¸¶´Ù º®¿¡¼­ CO2°¡ ³ª¿À°Ô µË´Ï´Ù. ±× ¶§¿¡´Â ¸ðµç ´ëÀå³»½Ã°æ °Ë»ç¿¡¼­ CO2¸¦ »ç¿ëÇÒ ¿¹Á¤ÀÔ´Ï´Ù.


[References]

1) Cotten ´ëÀå³»½Ã°æ»ðÀÔ¹ý PDF (¾ÏÈ£ÀÖÀ½)

2) [ȯÀÚ¿ë] ´ëÀåÁ¤°á ¼³¸í YouTube µ¿¿µ»ó (2016³â »ï¼º¼­¿ïº´¿ø °Ç°­°ËÁø¼¾ÅÍ ±è³²ÀÎ)

3) ¿¹º´´ö. üÀ§ º¯È¯°ú º¹ºÎ ¾Ð¹Ú (³»½Ã°æÇÐȸ ¼¼¹Ì³ª)

4) Oil-lubricated colonoscopy: easier and less painful? Endoscopy 2005;37:340-5 - seed oil (corn oil)À» Ãß°¡ÇÏ¿´´õ´Ï ´õ ÁÁ¾Ò´Ù´Â Èï¹Ì·Î¿î ¿¬±¸

5) Fabrication of an inexpensive but effective colonoscopic simulator JSLS 2017; 21: e2017.00002

6) Cap ´ëÀå³»½Ã°æ

7) ´ëÀå³»½Ã°æ»ðÀÔÀÇ Á¤¼® (ºÎ»êÀÇ´ë ¹éµ¿ÈÆ)

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.