PRELIMINARY EXPERIENCE WITH THE NOVEL MOTORIZED SPIRAL ENTEROSCOPE (POWERSPIRAL) FOR SMALL BOWEL DISEASES

Aims A Novel Motorized Spiral Enteroscope (PowerSpiral, Olympus corp) has been recently presented with promising ability to reduce duration and increase insertion depth of enteroscopy. Our primary endpoint was to evaluate efficacy of PowerSpiral enteroscope in the visualization of the small bowel. Secondary endpoint was to evaluate diagnostic yield and safety.

Methods A prospective observational study was conducted in all patients undergoing PowerSpiral enteroscopy at our Institution from June 2019 to November 2019. Data collected were patients’ demographic characteristics, indication to procedure, total procedure time, depth of maximum insertion, diagnostic yield and adverse events.

Results Thirty-one patients were included in the study. Three patients were excluded as it was not possible to pass the esophagus and 28 patients were finally analyzed (17 males, mean age 57 ±15 years); 19 patients (67,9%) underwent anterograde enteroscopy and 9 patients (32.1%) retrograde enteroscopy. The most common indications for the procedure were vascular lesions (32,1%), polyps (17.9%) and ulcers (14.3), previously detected by capsule endoscopy or radiology techniques. Twelve patients (42.9%) had previous abdominal surgery. The mean total procedure time was 61 minutes (SD ±22). The mean depth of maximum insertion was 521± 100 cm for anterograde enteroscopy. In 2 cases of anterograde enteroscopy the terminal ileum was reached and in 1 case a complete small bowel exploration was achieved. The diagnostic yield was 71.4%, with lower rate in patients with previous abdominal surgery (50%). No serious adverse events were observed during the procedure.

Conclusions Preliminary experience shows the new PowerSpiral enteroscope as an effective and safe device for the exploration of the small bowel with higher insertion depth and lower procedure time compared with previously available enteroscopes.