Establishing a flexible sigmoidoscopy/colonoscopy program for surgical residents. The University of Illinois experience.

The clinical value of lower gastrointestinal endoscopy and the requirement of the American Board of Surgery for endoscopic training mandate establishing a program in flexible sigmoidoscopy and colonoscopy for all surgical residents. In a 12-month period, the surgical residents at the authors' institution performed 599 flexible sigmoidoscopic and 116 total colonoscopic examinations under the supervision of two attending colorectal surgeons, with no mortality and a 0.03 per cent morbidity. There was an average of 42 endoscopic examinations per resident for the 3-week training period. Three hundred seventy (62%) of the flexible sigmoidoscopic examinations were for screening and 229 (38%) were for the evaluation of symptomatic patients. Colorectal polyps were identified in 68 patients (11.4%) and carcinoma in 14 patients (1.9%). Forty-nine per cent of the colonoscopic examinations were for endoscopic polypectomy. Sixty-four per cent of patients with more than one adenomatous polyp harbored polyps in different surgical segments of the colon. Every resident was able to perform flexible sigmoidoscopy safely by the end of the 3-week training period, and in addition, the residents rated their endoscopic experience as a valuable part of their surgical training.