Yes. And Yes.
- Using CO2 is a great for colonoscopy for several reasons: a) improved patient tolerability, b) improved cecal intubation rate, c) improves therapeutic possibilities as the colon does not get distended as much as compared to plain air, thus keeping the lesion at a better position and also decreasing chances of perforation. The latter is based on the “balloon-effect”. The more a balloon (colon) is inflated the higher the chances of laceration and perforation. Also, the more a balloon or colon is inflated, the thinner its wall becomes. Thus, when snaring a polyp of a distended colon, the chances of damage (perforation and burn) are increased.
- Regarding water 💧 or hydro/colonoscopy, there are many pros: a) less colon distinction and thus improved patient tolerability, b) cleaning the colon of remnant debris, c) stimulating the colon to move onto the scope (yes, water does stimulate colon motility), d) ability to perform underwater inspection and also resection of lesions, e) less change of electrosurgical damage (as water disperses the electricity applied to the polyp base), f) flushing water facilitates ileum intubation (Quick tip video coming soon 😃).