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Colonoscopy is less effective in the proximal compared with the distal colon.

To describe the success rate, yield, and safety of retroflexion of the right side of the colon after a careful forward-viewing examination.

Prospective observational study.

Tertiary-care hospital outpatient endoscopy center and associated ambulatory surgery center.

A total of 1000 consecutive adults undergoing elective screening or surveillance colonoscopy, without previous bowel resection, inflammatory bowel disease, or polyposis syndromes.

After cecal intubation, a careful examination of the cecum to the hepatic flexure was performed in the forward view with removal of all identified polyps. The colonoscope was then reinserted to the cecum and retroflexed, and examination was performed to the hepatic flexure in retroflexion.