The so-called painless gastroscopy is a gastroscopy performed under anesthesia. It is generally considered necessary, but painless colonoscopy has both advantages and disadvantages. Why? When doing gastroscopy, patients usually feel very reactive, bloating, nausea and vomiting, which can seriously affect the smooth progress of the examination, so using painless gastroscopy not only allows patients to avoid pain, but also allows doctors to examine carefully and avoid missing lesions. On the other hand, if we do painless colonoscopy, patients cannot cooperate under anesthesia, which sometimes increases the difficulty of the doctor’s operation and the chance of complications, so I personally think that only a very small number of patients with serious adhesions or long colon need painless colonoscopy. In fact, colonoscopy requires a lot of operating skills. With personal experience of more than 1000 cases of colonoscopy, more than 90% of patients do not have too much pain. The goal of colonoscopy is to reach the cecum, the length of the colon in adults is about 1.5m, colonoscopy needs to be shortened on the mirror body, to reach the cecum, generally into the mirror is 80-90cm, if in the process of entering the mirror, can always pay attention to keep the colon shortened state, the patient will not feel too much pain. So how to do this? First, it is recommended that a single operator, the so-called single operator is the insertion of the mirror and the operation of the angle knob are completed by a physician, which is conducive to two-handed cooperation in the operation of the shortening of the colon, the nurse is only to help when needed to carry out abdominal compression and help patients change position; second, relaxed operation, not only the patient’s abdomen should be relaxed, the examiner should also be relaxed, if the operation of the arm is too tense, it will certainly conduct to the front of the mirror, which is not conducive to the operation of the shortening of the colon. Third, as little inflation as possible, especially for beginners, over-inflation will increase the angle of the intestinal collaterals, making the operation more difficult, and over-inflation will also make the patient feel bloated; fourth, specifically in the operation process, you need to understand the three-dimensional anatomical concept of the colon, especially at the junction of recto-b, understanding that the junction of the colon is generally extended to the left posterior is not difficult to pass, sometimes let the assistant in the If you can pass through the recto-b junction without collaterals, you can think that the colonoscopy has completed one-third; after that, in the sigmoid section, always pay attention to keep the intestine shortened as much as possible, and if you keep the mirror in about 30 cm when passing through the descending b junction, you can think that the colonoscopy has completed two-thirds; after that, pay attention to compress the left lower abdomen when passing through the splenic flexure to prevent the sigmoid colon from collaterals again When passing through the transverse colon, the endoscope should be rotated clockwise at the time of insertion, which can sometimes effectively prevent colon collapse in the transverse colon. When finally reaching the cecum, try to control the insertion depth of the colonoscope within 90 cm. The goal of colonoscopy is of course to be fast and good, but the main thing is to make the patient suffer as little as possible while ensuring safety and not missing early lesions.