Deep enteroscopy with standard endoscopes using a novel through-the-scope balloon
submitted 28 October 2013
accepted after revision 12 February 2014
23 July 2014 (eFirst)
Background and study aims: A new on-demand enteroscopy (ODE) device has been designed to allow deep enteroscopy using a standard adult colonoscope with the aid of a novel through-the-scope balloon. The aims of the current study were to establish the feasibility, efficacy, and safety of ODE in performing anterograde and retrograde enteroscopy.
Patients and methods: A retrospective, single-center study of 28 consecutive deep ODE procedures (11 anterograde and 17 retrograde) was performed. Diagnostic yield, therapeutic yield, technical success, procedure time, depth of maximal insertion (DMI), time to DMI, and adverse events were recorded.
Results: The mean diagnostic and therapeutic yields were 45 % and 36 % for anterograde enteroscopy and 59 % and 47 % for retrograde enteroscopy, respectively. Technical success was achieved in 100 %. For anterograde enteroscopy, the mean total procedure time was 24 minutes, with a mean DMI of 1.2 m. For retrograde enteroscopy, the mean total procedure time was 31 minutes, with a mean DMI of 1.1 m. No adverse events were recorded.
Conclusion: Deep enteroscopy using a novel through-the-scope balloon and standard endoscope appeared to be feasible and safe, with rapid procedures times.
- 1 Gerson LB. Small-bowel enteroscopy. Endoscopy 2013; 45: 292-295
- 2 Mehdizadeh S, Ross A, Gerson L et al. What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers. Gastrointest Endosc 2006; 64: 740-750
- 3 Efthymiou M, Desmond PV, Brown G et al. SINGLE-01: a randomized, controlled trial comparing the efficacy and depth of insertion of single- and double-balloon enteroscopy by using a novel method to determine insertion depth. Gastrointest Endosc 2012; 76: 972-980
- 4 Cotton PB, Eisen GM, Aabakken L et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
- 5 Mehdizadeh S, Han NJ, Cheng DW et al. Success rate of retrograde double-balloon enteroscopy. Gastrointest Endosc 2007; 65: 633-639
- 6 Rahmi G, Samaha E, Vahedi K et al. Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy. J Gastroenterol Hepatol 2013; 28: 992-998
- 7 Khashab MA, Lennon AM, Dunbar KB et al. A comparative evaluation of single-balloon enteroscopy and spiral enteroscopy for patients with mid-gut disorders. Gastrointest Endosc 2010; 72: 766-772
- 8 Sanaka MR, Navaneethan U, Kosuru B et al. Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease. Clin Gastroenterol Hepatol 2012; 10: 910-916
- 9 Messer I, May A, Manner H et al. Prospective, randomized, single-center trial comparing double-balloon enteroscopy and spiral enteroscopy in patients with suspected small-bowel disorders. Gastrointest Endosc 2013; 77: 241-249
- 10 May A, Manner H, Aschmoneit I et al. Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small-bowel vascular malformations. Endoscopy 2011; 43: 477-483
- 11 Upchurch BR, Sanaka MR, Lopez AR et al. The clinical utility of single-balloon enteroscopy: a single-center experience of 172 procedures. Gastrointest Endosc 2010; 71: 1218-1223
- 12 Frieling T, Heise J, Sassenrath W et al. Prospective comparison between double-balloon enteroscopy and spiral enteroscopy. Endoscopy 2010; 42: 885-888
- 13 Sanaka MR, Navaneethan U, Upchurch BR et al. Diagnostic and therapeutic yield is not influenced by the timing of small-bowel enteroscopy: morning versus afternoon. Gastrointest Endosc 2013; 77: 62-70
- 14 May A, Nachbar L, Schneider M et al. Push-and-pull enteroscopy using the double-balloon technique: method of assessing depth of insertion and training of the enteroscopy technique using the Erlangen Endo-Trainer. Endoscopy 2005; 37: 66-70
- 15 Adler SN, Bjarnason I, Metzger YC. New balloon-guided technique for deep small-intestine endoscopy using standard endoscopes. Endoscopy 2008; 40: 502-505
- 16 Heine GD, Hadithi M, Groenen MJ et al. Double-balloon enteroscopy: indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease. Endoscopy 2006; 38: 42-48
- 17 Ell C, May A, Nachbar L et al. Push-and-pull enteroscopy in the small bowel using the double-balloon technique: results of a prospective European multicenter study. Endoscopy 2005; 37: 613-616
- 18 Takano N, Yamada A, Watabe H et al. Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011; 73: 734-739
- 19 Tontini GE, Grauer M, Akin H et al. Extensive small-bowel diverticulosis identified with the newly introduced On Demand Enteroscopy system. Endoscopy 2013; 45: E350-351