COLONOSCOPIC TATTOOING PROTOCOL

Colonoscopic tattooing protocol

Placing tattoos in the colon is now common practice in order to mark lesions prior to surgery or for endoscopic follow-up. An audit in our unit showed wide variation in the technique used as well as the number and placement of tattoos. Published studies confirm such variation in technique as well as subsequent variation in serosal visualisation at surgery. To address this issue, we have developed a standardised, evidence-based protocol for tattooing during colonoscopy.
 
The procedure involves a 'no-spill technique' with a saline lift to minimise leakage and resulting complications. To maximise visualisation at surgery (particularly at laparoscopy) three tattoos are placed at 120 degrees to each other 3cm from the lesion. Site of placement (distal for right-sided lesions, proximal for left-sided lesions, and distal for rectosigmoid lesions) facilitates surgical decision making regarding resection margins.

The protocol was presented as a poster at the BSG annual conference 2009. To download the abstract, click HERE. To download a pdf document poster of the protocol, click HERE.

The protocol is free to use, but we would request that the copyright is recognised and we are credited appropriately.