Background and study aims: Retrograde single-balloon enteroscopy (RSBE) facilitates evaluation of the distal
small bowel and provision of appropriate therapy when necessary. Intubation of the
terminal ileum (TI) is a major rate-limiting step, with failure rates as high as 30 %.
Cap-assisted endoscopy has proven beneficial in other aspects of endoscopy. We have
noticed that it similarly aids in TI intubation during RSBE by facilitating opening
of the ileocecal valve (ICV). The primary aim of this study was to measure the TI
intubation rate using cap-assisted RSBE. Other procedural details and outcomes were
also measured.
Patients and methods: A total of 36 consecutive RSBEs performed between July 2011 and May 2014 at the Medical
University of South Carolina were retrospectively reviewed. All procedures were performed
or supervised by our center’s small bowel endoscopist (ASB). Outcomes measured included
TI intubation rate, procedure time, depth of maximal insertion (DMI), diagnostic yield
(DY), therapeutic yield (TY), and complications.
Results: The TI intubation rate was 97 % (35 /36). The one failure was due to stool completely
obscuring the cecum. Median procedure time was 54 minutes, with a mean DMI of 68 cm
beyond the ICV. The technical success rate was 86 %, whereas DY and TY were 61 % and
25 %, respectively. There were no complications. The study was limited in that it
involved a single endoscopist at a single center.
Conclusions: Cap-assisted RSBE results in a high TI intubation rate, without compromise to safety
or procedural yield.
