Aims
Loop formation remains one of the main factors prolonging colonoscopy, often necessitating manual abdominal pressure or patient repositioning.Abdominal compression devices (ACDs) such as elastic binders or adjustable belts provide continuous counter-pressure, potentially preventing loop formation and facilitating cecal intubation.This prospective study aimed to evaluate the impact of ACD use on cecal intubation time and procedural performance during colonoscopy in a Moroccan tertiary centre.
Methods
A prospective comparative trial was conducted in our Hepato-Gastroenterology Department, from January 2023 to October 2025.A total of 220 consecutive adult patients undergoing diagnostic or screening colonoscopy were enrolled and randomly assigned to either:
ACD group (n = 110) – colonoscopy performed using an adjustable abdominal compression belt,
Control group (n = 110) – conventional colonoscopy without compression.Endpoints included:
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Primary: mean cecal intubation time (CIT) in minutes.
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Secondary: need for manual pressure, patient position change, and procedure-related discomfort or adverse events.All procedures were performed by experienced endoscopists under conscious sedation. Statistical analysis was carried out using SPSS 26.0; p < 0.05 was considered significant.
Results
Mean age was 55 ± 12 years; 58 % were female.Cecal intubation was achieved in 98.2 % overall.
Mean CIT: significantly shorter with ACD (5.9 ± 1.8 min) compared with control (7.8 ± 2.3 min; p < 0.001).
Manual abdominal pressure: required in 13.6 % of ACD cases vs 47.2 % of controls (p < 0.001).
Position change: needed in 16.3 % with ACD vs 40.9 % without (p = 0.002).
Total procedure time: 11.2 ± 3.9 min (ACD) vs 13.7 ± 4.4 min (control; p = 0.01).No adverse events or device-related complications were recorded, and patient tolerance scores were higher in the ACD group (p = 0.04*).
Conclusions
In this single-centre prospective study, the use of an abdominal compression device during colonoscopy significantly reduced cecal intubation and total procedure times, while minimising the need for manual pressure and patient repositioning, without compromising safety or comfort.These findings support the routine use of ACDs as a simple, non-invasive, and cost-effective adjunct to improve procedural efficiency, particularly in patients with redundant or difficult colons.