scholarly journals Motorized Spiral Enteroscopy: to infinity and beyond?

2021 ◽  
Vol 84 (3) ◽  
pp. 520-521
Author(s):  
T.G. Moreels ◽  
L Monino
Keyword(s):  
Small Bowel ◽  
Diagnostic Yield ◽  
Therapeutic Interventions ◽  
Clinical Consequence ◽  
Double Balloon Enteroscopy ◽  
Entire Small Bowel ◽  
Double Balloon ◽  
Surgically Altered Anatomy ◽  
Increased Risk ◽  
Spiral Enteroscopy

With the advent of device-assisted enteroscopy (DAE) in the early 2000s, endoscopic access to the entire small bowel is possible nowadays (1). And yet, there is still room for improvement. Total enteroscopy remains a time-consuming procedure, often combining the antegrade (oral) and retrograde (anal) approach with only a reasonable chance to obtain complete endoscopy of the entire small bowel (2). Therefore, the aim is to go faster, deeper and to perform more advanced therapeutic interventions within the long and tortuous small bowel. Moreover, DAE was also shown to be effective to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy and to complete colonoscopy in patients with previously incomplete conventional colonoscopy due to long dolichocolon (3). The latest DAE development is Motorized Spiral Enteroscopy (MSE), initially conceptualized as a manually driven rotational spiral overtube by Paul A. Akerman, and further developed and commercialized as a motorized spiral overtube by the Olympus Medical Systems Corporation (4). Initial feasibility trials have shown that MSE can compete with already available DAE techniques (single- and double-balloon enteroscopy) with regard to diagnostic yield and endotherapy within the small bowel (5,6). However, being a short type enteroscope of 168 cm (as compared to the 200 cm long single- and double-balloon enteroscopes), MSE appears to be even more effective in obtaining deep and total enteroscopy with a relatively short procedural duration (2,6). In addition, the working channel diameter is increased to 3.2 mm (as compared to 2.8 mm) with an extra irrigation channel, facilitating therapeutic interventions within the small bowel. This faster and deeper (but more aggressive) enteroscopy technique comes with the price of an increased risk of mucosal injuries (ranging from superficial bruising to laceration and even perforation) within the oesophagus and the small bowel, luckily remaining asymptomatic most of the time without any clinical consequence (6). So far, this promising new technique has the potential of becoming a gamechanger in the still evolving field of deep enteroscopy.

scholarly journals The Diagnostic Value of Double-Balloon Enteroscopy in Children with Small Bowel Disease: Report of 31 Cases

2009 ◽  
Vol 23 (9) ◽  
pp. 635-638 ◽  
Author(s):  
Wei Liu ◽  
Chundi Xu ◽  
Jie Zhong
Keyword(s):  
Small Bowel ◽  
Bowel Disease ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Small Bowel Disease ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Entire Small Bowel ◽  
Double Balloon ◽  
Diagnostic Modalities

BACKGROUND AND OBJECTIVE: Before the introduction of double-balloon enteroscopy (DBE), it was impossible to visualize the entire small bowel. Its diagnostic yield has been assessed in adults, but not yet in children. The present retrospective study evaluated the diagnostic usefulness and safety of DBE in children with suspected small bowel disease.METHODS: Between June 2003 and June 2007, 31 patients (19 boys and 12 girls, age range three to 14 years) with suspected small bowel disease underwent DBE after receiving negative evaluations using other diagnostic modalities.RESULTS: There were no severe complications. In two patients, the entire small bowel was viewed using oral and anal approaches, and for the remaining 29 patients, only one approach was used. The sites of disease in were identified in 25 of 31 cases (80.65%). The bleeding source was found in 21 of 27 patients with obscure gastrointestinal bleeding (diagnostic rate of 77.78%). Different diseases were identified in four children with chronic diarrhea.CONCLUSION: DBE is a safe and effective method to diagnose patients with suspected small bowel disorders.

scholarly journals The Evolution of Device-Assisted Enteroscopy: From Sonde Enteroscopy to Motorized Spiral Enteroscopy

2021 ◽  
Vol 8 ◽  
Author(s):  
Fredy Nehme ◽  
Hemant Goyal ◽  
Abhilash Perisetti ◽  
Benjamin Tharian ◽  
Neil Sharma ◽  
...  
Keyword(s):  
Small Bowel ◽  
Diagnostic Yield ◽  
Double Balloon Enteroscopy ◽  
New Developments ◽  
Balloon Enteroscopy ◽  
Entire Small Bowel ◽  
Bowel Diseases ◽  
Spiral Enteroscopy ◽  
Single Balloon ◽  
Single Balloon Enteroscopy

The introduction of capsule endoscopy in 2001 opened the last “black box” of the gastrointestinal tract enabling complete visualization of the small bowel. Since then, numerous new developments in the field of deep enteroscopy have emerged expanding the diagnostic and therapeutic armamentarium against small bowel diseases. The ability to achieve total enteroscopy and visualize the entire small bowel remains the holy grail in enteroscopy. Our journey in the small bowel started historically with sonde type enteroscopy and ropeway enteroscopy. Currently, double-balloon enteroscopy, single-balloon enteroscopy, and spiral enteroscopy are available in clinical practice. Recently, a novel motorized enteroscope has been described with the potential to shorten procedure time and allow for total enteroscopy in one session. In this review, we will present an overview of the currently available techniques, indications, diagnostic yield, and complications of device-assisted enteroscopy.

scholarly journals Complimentary Imaging Modalities for Investigating Obscure Gastrointestinal Bleeding: Capsule Endoscopy, Double-Balloon Enteroscopy, and Computed Tomographic Enterography

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ye Chu ◽  
Sheng Wu ◽  
Yuting Qian ◽  
Qi Wang ◽  
Juanjuan Li ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Obscure Gastrointestinal Bleeding ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Computed Tomographic ◽  
Double Balloon ◽  
Complementary Value

Objectives. The complimentary value of computed tomographic enterography (CTE) and double-balloon enteroscopy (DBE) combined with capsule endoscopy (CE) was evaluated in the diagnosis of obscure gastrointestinal bleeding (OGIB).Methods. Patients who received CE examinations at Ruijin Hospital between July 2007 and July 2014 with the indication of OGIB were identified, and those who also underwent DBE and/or CTE were included. Their clinical information was retrieved, and results from each test were compared with findings from the other two examinations.Results. The overall diagnostic yield of CE was comparable with DBE (73.9% versus 60.9%) but was significantly higher than the yield of CTE (87% versus 25%,p<0.001). The diagnostic yield of angiodysplasia at CE was significantly higher than CTE (73% versus 8%,p<0.001) and DBE (39.1% versus 17.4%,p=0.013), while no significant difference was found between the three approaches for small bowel tumors. DBE and CTE identified small bowel diseases undetected or undetermined by CE. Conversely, CE improved diagnosis in the cases with negative CTE and DBE, and findings at initial CE directed further diagnosis made by DBE.Conclusions. Combination of the three diagnostic platforms provides complementary value in the diagnosis of OGIB.

scholarly journals Causes and Clinical Characteristics of Small Bowel Bleeding in Northern Vietnam

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Cong Long Nguyen ◽  
Khac Khiem Pham ◽  
Canh Hiep Nguyen ◽  
Hoang Nam Nguyen ◽  
Tran Tien Dao ◽  
...  
Keyword(s):  
Small Bowel ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
High Detection Rate ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Computed Tomographic ◽  
Double Balloon ◽  
Common Causes ◽  
Vietnamese Population

Aim. Causes, clinical features, and diagnostic approaches for small bowel (SB) bleeding were analyzed to derive recommendations in dealing with this clinical condition. Methods. We included 54 patients undergoing surgical treatment for SB bleeding, from January 2009 to December 2019. Detailed clinical data, diagnosis procedures, and causes of bleeding were collected. Results. Among 54 cases with SB bleeding, the most common causes were tumors (64.8%), followed by angiopathy (14.8%), ulcers (9.3%), diverticula (5.6%), tuberculosis (3.7%), and enteritis (1.9%). Most tumors (32/35 cases, 91.4%) and vascular lesions (8/8 cases, 100%) were located in the jejunum. The incidence of tumors was higher in the older (30/41 cases, 73.1%) than that in patients younger than 40 years of age (5/13 cases, 38.5%, P < 0.01 ). Common initial findings were melena (68.5%) and hematochezia (31.5%). The overall diagnostic yield of computed tomographic enterography (CTE) was 57.4% (31/54 cases), with the figures for tumors, vascular lesions, and inflammatory lesions being 71.4% (25/35 cases), 62.5% (5/8 cases), and 12.5% (1/8 cases), respectively. Double-balloon enteroscopy (DBE) definitively identified SB bleeding sources in 16/22 (72.7%) patients. Conclusion. Tumors, angiopathy, ulcers, and diverticula were the most common causes of SB bleeding in Northern Vietnamese population. CTE has a high detection rate for tumors in patients with SB bleeding. CTE as a triage tool may identify patients before double-balloon enteroscopy because of the high prevalence of SB tumors.

Double-Balloon Enteroscopy and Capsule Endoscopy Have Comparable Diagnostic Yield in Small-Bowel Disease: A Meta-Analysis

2008 ◽  
Vol 6 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Shabana F. Pasha ◽  
Jonathan A. Leighton ◽  
Ananya Das ◽  
M. Edwyn Harrison ◽  
G. Anton Decker ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Bowel Disease ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Small Bowel Disease ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Double-Balloon Enteroscopy (DBE) and Capsule Endoscopy (CE) Have a Comparable Diagnostic Yield in Patients with Suspected Small Bowel Disease: A Meta-Analysis

2007 ◽  
Vol 65 (5) ◽  
pp. AB364 ◽  
Author(s):  
Shabana F. Pasha ◽  
Jonathan A. Leighton ◽  
Ananya Das ◽  
M. Edwyn Harrison ◽  
G. Anton Decker ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Bowel Disease ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Small Bowel Disease ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Diagnostic yield, therapeutic impact, and complications of double-balloon enteroscopy in patients with small-bowel pathology

2007 ◽  
Vol 22 (5) ◽  
pp. 1223-1226 ◽  
Author(s):  
R. Barreto-Zuñiga ◽  
F. I. Tellez-Avila ◽  
N. C. Chavez-Tapia ◽  
M. A. Ramirez-Luna ◽  
E. Sanchez-Cortes ◽  
...  
Keyword(s):  
Small Bowel ◽  
Diagnostic Yield ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Therapeutic Impact ◽  
Double Balloon

Indications and Diagnostic Yield of Double Balloon Enteroscopy in a Tertiary Care Setting: An Analysis of 527 Cases with Suspected Small Bowel Diseases

2008 ◽  
Vol 67 (5) ◽  
pp. AB268
Author(s):  
Jumpei Kondo ◽  
Shingo Tsuji ◽  
Hideki Iijima ◽  
Masahiko Tsujii ◽  
Tsutomu Nishida ◽  
...  
Keyword(s):  
Small Bowel ◽  
Care Setting ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Bowel Diseases ◽  
Tertiary Care Setting ◽  
Small Bowel Diseases
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