<caption><image_110>The image is a document titled "Routine rectal retroflexion during colonoscopy has a low yield for neoplasia". The document is written in Spanish and has a blue background. The title of the document is in red and white text at the top of the page. Below the title, there is a subtitle in Spanish that reads "1502 pacientes, Retrovision exitosa 93.9% (1411) 43 pollos en recto distal 33 se vieron con la inserción y la retróflexion". 

The document appears to be a report on the treatment of colonoscopes during the COVID-19 pandemic, as indicated by the text in the text below the title. The report is titled "Angulo de vision de 140° y 170° similares" which translates to "Vision of the vision of 140° and 170°" in English.

At the bottom of the image, there are two bullet points in Spanish, one in English and one in Spanish.</caption><transcript><audio_111> tienen muy bajo campo de aumentar el rendimiento de encontrar pólipos. El profesor Douglas Reyes aquí muestra unos casos y encontró que 33 casos de pólipos en el recto</transcript><caption><image_112>The image shows a man standing at a podium and speaking into a microphone. He is wearing a suit and glasses and appears to be giving a presentation. The background is white and there is a red logo on the top left corner. On the right side of the image, there is text in Spanish that reads "Routine rectilización revolucionación during colonoscopy has a new yield for new zealand". Below the text, there are two bullet points that explain the results of the presentation.</caption><transcript><audio_113> vieron con la inserción y la retroflexión se vieron siete que no se vieron entrando. De esos siete, seis eran hiperplásticos y uno era adenomatoso. Pero yo creo y estoy de acuerdo que habrá casos especiales en los cuales, dependiendo del paciente, se puede hacer la retrovisión. Por ejemplo,</transcript><caption><image_114>The image is a collage of two photographs side by side. The first photograph on the left shows a close-up of a person's stomach, which appears to be swollen and inflamed. The stomach is red and swollen, with some areas of the skin appearing red and irritated. The image is labeled "Enero 2006" and "5 años después" which translates to "5 years despues" in English.

In the second photograph, the stomach appears to have a large, inflamed stomach, with a large amount of blood vessels visible. The blood vessels appear to be inflamed and swollen. There is a small amount of redness and swelling around the edges of the stomach. The person's tongue is also swollen and there is a black marker on the right side of the image, indicating that the image was taken during the year 2006 and 2011.</caption><transcript><audio_115> este es un caso en que se hizo retrovisión y no hay absolutamente nada pero 11 años después hay un cáncer de recto el mismo paciente yo creo que habrá que seleccionarlo si un paciente molesta mucho yo le hago retrovisión de recto y me acuerdo de esta diapositiva</transcript><caption><image_116>The image is a collage of four images that show the results of a rectal perforation during colonoscopy retrosclerosis. The images are arranged in a grid-like pattern, with each image representing a different stage of the procedure.

The first image on the top left shows a close-up of a person's eye with a pinkish-purple color. The person appears to be in pain or discomfort, with their eyes closed and their mouth slightly open. The second image in the top right shows the same person with a redish-red color, indicating that the procedure has been performed. The third image shows a closer view of the person's face, with the eyes closed. The fourth image shows an enlarged area with a small amount of blood vessels visible. The text on the image reads "39.064 Colonoscopias" and "4 cases 0.10/1000".

At the bottom of the image, there is a label that reads "GIE 2009-09-960-3". This indicates that the image was taken in an academic center.</caption><transcript><audio_117> La tasa de perforación es muy baja con la retrovisión, de tal suerte que es un procedimiento seguro, excepto cuando hay colitis proctitis ulcerativa o hay antecedentes de radioterapia.</transcript><caption><image_118>The image shows a man standing at a podium and speaking into a microphone. He is wearing a suit and glasses and appears to be giving a presentation. The background is dark and there is a blue banner on the left side of the image with white text. The text on the banner reads "Otras indicadores" which translates to "Otros indicators" in English. 

Below the banner, there is an image of a man in a suit, who is likely giving a speech or presentation. He has a serious expression on his face and is gesturing with his hands as he speaks. The image is likely from a presentation or event.</caption><transcript><audio_119> no se puede la retrovisión. Otros indicadores, y este es el reto para el futuro de todos nosotros, es la tasa de cáncer post-coronoscopia, la tasa de pérdida de adenomas, adenomas post-coronoscopias,</transcript><transcript><audio_120> de detección de pólipos en toda la cronoscopia la tasa de pérdida de enomas avanzados y se llama se llama un enoma avanzado si vive de más de 10 milímetros y es disponible</transcript> Retrovision the rectum has a very low field of increasing the performance of finding polyps. Professor Douglas re here shows some cases and found that 33 cases of polyps in the distal rectum were seen with insertion and retroflexion, seven were seen that were not seen entering. Of those seven, six were hyperplastic and one was adenomatous, but I believe and agree that there will be special cases in which, depending on the patient, retrovision can be done. For example, this is a case in which a retrovision was done and there is absolutely nothing but 11 years later there is rectal cancer in the same patient. I think it will have to be selected. If a patient is very bothersome, I do a retrovision of the rectum and I remember this  slide in case there is a problem in the future the perforation rate is very low with retrovision. Therefore, it is a safe procedure except when there is ulcerative colitis, proctitis, there is a history of radiotherapy and there may be less distensibility, no retrovision is used, other indicators  and this is the challenge for the future of all of us is the rate of cancer post colonoscopy the rate of loss of adenomas post colonoscopy adenomas the rate of detection of polyps throughout the chronoscopy the rate of loss of advanced adenomas and it is called it is called a  advanced aoma if I saw more than 10 mm you have high
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