Retroflexion in the colon: A useful and safe technique in the evaluation and resection of sessile polyps during colonoscopy

Aline Charabaty Pishvaian, Firas H. Al-Kawas

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


OBJECTIVE: Endoscopic polypectomy has become the standard management approach for colon polyps. Three factors can make endoscopic resection of colonic polyps difficult: size, configuration, and location. We describe the use of retroflexion in the colon as a useful and routine technique using a standard colonoscope for the resection of difficult sessile polyps. METHODS: Fifteen patients in whom the retroflexion technique was used for polyp removal were prospectively identified. Each polyp was visualized and resected using both a forward and retroflexed view. RESULTS: Nine women and six men were identified between the ages of 49 and 81 years. The 15 polyps were located in the cecum (3), ascending colon (3), hepatic flexure (3), splenic flexure (2), descending colon (2), and sigmoid colon (2). All the polyps were sessile and their largest diameter ranged from 20 mm to 50 mm. Retroflexion combined with forward viewing allowed for a better assessment of the size and extent of all the polyps compared with forward viewing alone. All polyps, except two, were completely resected during the first session, using both the prograde and retroflexion approaches. No complications from retroflexion of the colonoscope, including perforation or bleeding, occurred. CONCLUSION: Retroflexion complements the conventional prograde inspection of sessile polyps that are only partially visualized on prograde view alone. Retroflexion allows a complete assessment of the lesions' size and extent and aid in their complete removal.

Original languageEnglish (US)
Pages (from-to)1479-1483
Number of pages5
JournalAmerican Journal of Gastroenterology
Issue number7
StatePublished - Jul 1 2006
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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