Advertisement

New Designs in Balloon Enteroscopes

  • Hironori YamamotoEmail author
  • Tomonori Yano

Abstract

Double-balloon endoscopy (DBE) has been a significant advancement in the endoscopic diagnosis and treatment of small intestinal disorders. What makes the device particularly remarkable is not only its ability to perform deep enteroscopy, but also the fact that it has therapeutic capabilities as well. The new therapeutic EN-580T has improved intervention capability with a 3.2 mm accessory channel and improved image quality as well, despite maintaining the same outer diameter of 9.4 mm as the previous model. The new diagnostic EN-580XP has the same improved image quality as EN-580T despite having a much smaller outer diameter of 7.5 mm. These new enteroscopes are expected to improve clinical management as well as the research of small intestinal disorders. Double-balloon endoscopy for evaluation of the small intestine can also be performed in patients with surgically altered anatomy and difficult colons. A short EI-530B or EC-450BI5 scope is useful for ERCP in patients with a Roux-en-Y anastomosis and also in patients who have had prior difficult colonoscopies. Future technology may allow for automated insertion of the enteroscopes.

Keywords

Small intestine Enteroscopy Peutz-Jeghers syndrome Crohn’s disease Roux-en-Y Difficult colon 

Supplementary material

Video 18.1

A video showing the effective transmission of endoscopic control to the tip from the proximal endoscope shaft through the balloon overtube. The rotation and in-and-out motions are effectively transmitted through the overtube even with a looping of the shaft (MPG 25999 kb)

Video 18.2

A video showing clear image of intestinal villi with EN-580T. Both the close-up and distant images are well focused because of the long focus range (MP4 60313 kb)

References

  1. 1.
    Yamamoto H, Yano T, Kita H, Sunada K, Ido K, Sugano K. New system of double-balloon enteroscopy for diagnosis and treatment of small intestinal disorders. Gastroenterology. 2003;125(5):1556. author reply 1556–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Nishimura N, Yamamoto H, Yano T, Hayashi Y, Arashiro M, Miyata T, et al. Safety and efficacy of double-balloon enteroscopy in pediatric patients. Gastrointest Endosc. 2010;71(2):287–94.PubMedCrossRefGoogle Scholar
  3. 3.
    Kuno A, Yamamoto H, Kita H, Sunada K, Yano T, Hayashi Y, et al. Double-balloon enteroscopy through a Roux-en-Y anastomosis for EMR of an early carcinoma in the afferent duodenal limb. Gastrointest Endosc. 2004;60(6):1032–4.PubMedCrossRefGoogle Scholar
  4. 4.
    Haruta H, Yamamoto H, Mizuta K, Kita Y, Uno T, Egami S, et al. A case of successful enteroscopic balloon dilation for late anastomotic stricture of choledochojejunostomy after living donor liver transplantation. Liver Transpl. 2005;11(12):1608–10.PubMedCrossRefGoogle Scholar
  5. 5.
    Shimatani M, Matsushita M, Takaoka M, Koyabu M, Ikeura T, Kato K, et al. Effective “short” double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy: a large case series. Endoscopy. 2009;41(10):849–54.PubMedCrossRefGoogle Scholar
  6. 6.
    Hotta K, Katsuki S, Ohata K, Abe T, Endo M, Shimatani M, et al. A multicenter, prospective trial of total colonoscopy using a short double-balloon endoscope in patients with previous incomplete colonoscopy. Gastrointest Endosc. 2012;75(4):813–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Gay G, Delvaux M. Double-balloon colonoscopy after failed conventional colonoscopy: a pilot series with a new instrument. Endoscopy. 2007;39(9):788–92.PubMedCrossRefGoogle Scholar
  8. 8.
    Kaltenbach T, Soetikno R, Friedland S. Use of a double balloon enteroscope facilitates caecal intubation after incomplete colonoscopy with a standard colonoscope. Dig Liver Dis. 2006;38(12):921–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Pasha SF, Harrison ME, Das A, Corrado CM, Arnell KN, Leighton JA. Utility of double-balloon colonoscopy for completion of colon examination after incomplete colonoscopy with conventional colonoscope. Gastrointest Endosc. 2007;65(6):848–53.PubMedCrossRefGoogle Scholar
  10. 10.
    Hayashi Y, Sunada K, Yamamoto H. A prototype holder adequately supports the overtube in balloon-assisted ESD. Dig Endosc. 2014;26(5):682.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Medicine, Division of GastroenterologyJichi Medical UniversityShimotsukeJapan

Personalised recommendations