Distal attachments placed on the endoscope tip can improve visualization of the endoscopic field and have been applied for a variety of endoscopic procedures (eg, colonic insertion, detection, diagnosis, and treatment).1 Although manufactured distal attachments are commercially available, it may be necessary to prepare different types to suit different endoscopes because the distal outer diameters of endoscopes vary widely. In addition, cost-effectiveness leads to hesitation about the use of commercially available distal attachments in daily practice.