Intubation by dither-torquing. A. The shaft is torqued counterclockwise while advancing the shaft 10 to 15cm. B. The shaft is torqued clockwise while withdrawing the shaft 10 to 15 cm. Repetition of this cycle encourages the sigmoid to accordionize onto
Intubation by looping. A. The sigmoidoscope is advanced to the distal sigmoid. B. Counterclockwise torquing during further advancement loops the proximal sigmoid in front of the distal sigmoid. C. The looped sigmoid flattens the angle at the distal-descen
Intubation by elongation. A. The sigmoidoscope is advanced to the proximal sigmoid. B. Severe tip deflection prevents further advancement resulting in sigmoid elongation. C. Clockwise torquing and shaft withdrawal accordionizes the sigmoid.