Double right colon examination during colonoscopy has been advocated to reduce the risk of interval cancer in the right colon segment. Whether 2 examinations are necessary when the first examination is performed with a mucosal exposure device is uncertain. We documented the rates of missed adenomas, sessile serrated lesions, and hyperplastic polyps after an initial right colon segment examination by a high level detector using a mucosal exposure device.
At a single tertiary hospital outpatient practice, we prospectively collected data on the yield of a second examination of the right colon segment, after initial examination by a single high-detecting colonoscopist using a mucosal exposure device.
During the study period, 1331 eligible consecutive patients underwent colonoscopy. Right colon adenoma, sessile serrated lesion, and hyperplastic polyp miss rates were 15.8%, 14.1%, and 16.7%, respectively. Four percent of patients had adenomas detected in the right colon segment only with a second examination.
A second examination of the right colon segment is warranted, even when using a distal mucosal exposure device to perform colonoscopy.

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