Open Access Research article

Gastronet survey on the use of one- or two-person technique for colonoscopy insertion

Geir Hoff1, Moritz Volker1*, Michael Bretthauer2, Lars Aabakken3, Ole Høie4, Thomas deLange5, Ingrid Berset6, Øystein Kjellevold7, Tom Glomsaker8, Gert Huppertz-Hauss9, Ove Lange10 and Per Sandvei11

Author Affiliations

1 Dept of Medicine, Telemark Hospital, 3710 Skien, Norway

2 Cancer Registry of Norway, Oslo University Hospital, Montebello, 0304 Oslo, Norway

3 Oslo University Hospital Rikshospitalet, Dept of Medicine, 0027 Oslo, Norway

4 Dept of Medicine, Sørlandet Hospital Arendal, 4809 Arendal, Norway

5 Dept of Medicine, Bærum Hospital Vestre Viken HF, 1309 Rud, Norway

6 Dept of Medicine, Helse Sunnmøre HF, Ålesund Hospital, 6026 Ålesund, Norway

7 Telemark Hospital Kragerø, 3770 Kragerø, Norway

8 Dept of Surgery, Stavanger University Hospital, 4068 Stavanger, Norway

9 Dept of Medicine, Telemark Hospital, 3710 Skien, Norway

10 Dept of Medicine, Molde Hospital, Dept of Medicine, 6407 Molde, Norway

11 Dept of Medicine, Østfold Hospital Trust, 1603 Fredrikstad, Norway

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BMC Gastroenterology 2011, 11:73  doi:10.1186/1471-230X-11-73

Published: 14 June 2011



Usually, colonoscopy insertion is performed by the colonoscopist (one-person technique). Quite common in the early days of endoscopy, the assisting nurse is now only rarely doing the insertion (two-person technique). Using the Norwegian national endoscopy quality assurance (QA) programme, Gastronet, we wanted to explore the extent of two-person technique practice and look into possible differences in performance and QA output measures.


100 colonoscopists in 18 colonoscopy centres having reported their colonoscopies to Gastronet between January and December 2009 were asked if they practiced one- or two-person technique during insertion of the colonoscope. They were categorized accordingly for comparative analyses of QA indicators.


75 endoscopists responded to the survey (representing 9368 colonoscopies) - 62 of them (83%) applied one-person technique and 13 (17%) two-person technique. Patients age and sex distributions and indications for colonoscopy were also similar in the two groups. Caecal intubation was 96% in the two-person group compared to 92% in the one-person group (p < 0.001). Pain reports were similar in the groups, but time to the caecum was shorter and the use of sedation less in the two-person group.


Two-person technique for colonoscope insertion was practiced by a considerable minority of endoscopists (17%). QA indicators were either similar to or better than one-person technique. This suggests that there may be some beneficial elements to this technique worth exploring and try to import into the much preferred one-person insertion technique.