Transparent cap improves patients' tolerance of colonoscopy and shortens examination time by inexperienced endoscopists

OBJECTIVE: Up to 10% of colonoscopy procedures cannot be completed and polyps may be missed because of patients' discomfort and the endoscopists' technique. The aim of this study was to test the feasibility and safety of attaching a transparent cap to improve the outcome, especially for inexperienced endoscopists. METHODS: A total of 250 patients were randomized to undergoing either a cap-fitted colonoscopy (CCF) or a normal colonoscopy without a cap (NCCF). The procedures were performed by an experienced or inexperienced endoscopist, and the time to reach the cecum, the total colonoscopy time and the polyp detection rate were recorded. Visual analogue scales (VAS) assessing the severity of abdominal pain and distension were obtained. RESULTS: For the experienced endoscopist there was no difference between CCF and NCCF on the time to reach the cecum and the time for the whole procedure. But for the inexperienced endoscopist, both times were significantly shorter in the CCF group than in the NCCF group (9.48 min vs. 12.45 min; 18.50 min vs. 21.89 min, respectively, P < 0.05). No complication was observed except some abdominal pain and distension. The VAS scores of abdominal pain and distension were significantly lower in CCF group than those in the NCCF group for the two endoscopists. There was no significant difference in the number of polyps found between the two groups. CONCLUSION: A cap-fitted colonoscopy can shorten the examination time for inexperienced endoscopists. It can also reduce the patients' discomfort during the procedure.