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A short cap on the colonoscope tip has been found in some studies to improve polyp detection by flattening folds. It also facilitates salvage of endoscopic mucosal resection (EMR) by allowing very flat tissue to be removed, and in Asian studies, has been shown to increase cecal intubation rates and speed cecal insertion by trainees.
To test this last benefit, three U.S. fellows, novices at colonoscopy, were assigned colonoscopy procedures randomized to be done with or without the short cap. Independent cecal intubation was achieved by the fellows in 79% of procedures with the short cap versus in 67% without (P=0.04). Overall cecal intubation times, including salvage by the attending, were 13.7 minutes with cap versus 16.5 minutes without. In…