Figure 1.

Still images illustrating the technical details of the water method: a. air filled rectum; b. air removal collapses rectal lumen; c. infused water opens lumen; d. residual feces removed by suction; e. simultaneous water infusion and suction produce turbulence at the tip of the colonoscope to dislodge adherent feces from nearby mucosa; f & g. suction of luminal water minimizes distention; h & i. appendix opening; j & k. suction marks near appendix opening; l. difficult view due to excessive residual feces; m. insufflated air in the presence of excessive residual feces can produce air/fluid compartments to facilitate viewing of the lumen, but the preferred maneuver with the water method is water exchange to clear the view.