Cap-assisted colonoscopy involves the attachment of a distal transparent cap to the
end of the colonoscope. This method has several advantages, such as decreasing insertion
time [1] and enabling easy flattening of the mucosal folds, thus permitting visualization
of the hidden polyps behind the mucosal folds [2]. However, the use of cap-assisted colonoscopy in detecting adenomas is debatable
[1]
[3]. Until now, although the benefits of using a clear cap have been discussed, there
have been no discussions on how to use it. Therefore, this study suggests a “hooking
and dragging maneuver” ([Video 1]). This maneuver involves hooking the mucosal fold with the tip of the cap, dragging
the scope, scratching along the colon wall, and stretching multiple mucosal folds
simultaneously ([Fig. 1]). This technique allows the visualization of multiple posterior regions of the mucosal
fold at the same time, minimizing the hidden areas. Hooking points and dragging directions
on the cecum ([Fig. 2]), the ascending colon ([Fig. 3]), and the hepatic flexure ([Fig. 4]) are shown.
Video 1 “Hooking and dragging maneuver” as a standard maneuver in cap-assisted colonoscopy.
Source for graphical illustration: Park Sabeom.
Fig. 1 Schematic diagram of “hooking and dragging maneuver”. Source: Park Sabeom.
Fig. 2 Mucosal hooking points on the cecum.
Fig. 3 Mucosal hooking points on the ascending colon.
Fig. 4 Mucosal hooking points on the hepatic flexure.
Endoscopy_UCTN_Code_TTT_1AQ_2AB
Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques
in gastroenterological endoscopy. All papers include a high quality video and all
contributions are freely accessible online. Processing charges apply (currently EUR
375), discounts and wavers acc. to HINARI are available.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
