A big cecal lesion (6 x 4 cm) is resected by ESD. The case has been difficult due to poor maneuverability and bleeding during the procedure. At the end of the dissection, it was necessary to change the colonoscope and cap. A standard colonoscope with a distal diameter of 12 mm and a working channel of 3.7 mm has been used. We also had to change to a straight hood to improve visibility. Thanks to Dr. Rosón to help me in this case.