⁎3492 Cap-fitted gastroscopy improves visualisation and targeting of lesions.

Introduction: Adequate visualisation of lesions during gastroscopy (OGD)is essential for diagnosis, biopsy and targeted therapy.The duodenal bulb, D1-D2 junction, cardia and posterior gastric wall are difficult areas to examine because of instability of the endoscope tip or tangential approach. Simple cap-fitted gastroscopy (CF-OGD) improves visualisation by maintaining tip stability in the duodenal bulb and D1-D2 junction, allows manipulation of tangential sites to an "en-face" approach while maintaining a fixed distance between the scope tip and the lesion. Method: A recycled transparent cap from a Wilson-Cook Sixshooter(R) variceal ligator was evaluated prospectively during OGD by a single experienced endoscopist(YCK). Where visualisation or targeting for biopsy or therapy was deemed suboptimal due to endoscope tip instability or tangential approach, the examination was repeated using the same scope fitted with the cap. Results: 17 procedures were deemed necessary for CF-OGD for diagnosis or treatment. Males 9, mean age 62 years (27-89 years). Site of lesion: deformed duodenal bulb 7, D1-D2 junction 5, D2 1, posterior gastric wall 3, incisura 1, cardia 1, pylorus 1. Diagnostic entities: duodenal varix 1, duodenal ulcer 7, gastric ulcer 3, antral cancer 1, Crohn's disease duodenum 1, duodenal polyp 3, gastric polyp 1, duodenal gastric metaplasia 1. Additional procedures: targeted biopsy 7, injection of bleeding DU 3, polypectomy (2.5cm D1 polyp) 1. There were no problems encountered with intubation using the cap or complications. Conclusion: Simple cap-fitted gastroscopy is a useful adjunct to OGD to visualise difficult areas, obtain biopsies and target lesions for therapy.