Original ArticleDouble-balloon enteroscopy (push-and-pull enteroscopy) of the small bowel: feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease
Section snippets
Double-balloon enteroscopy (push-and-pull enteroscopy)
The prototype double-balloon enteroscopy (push-and-pull enteroscopy) system (Fujinon EN-450P5/20; Fujinon Inc, Saitama, Japan) (Fig. 1) consists of a high-resolution videoendoscope, with a working length of 200 cm and an outer diameter of 8.5 mm, and a flexible overtube with a length of 140 cm and an outer diameter of 12 mm. The working channel of the enteroscope has a diameter of 2.2 mm. Latex balloons are attached at the tip of the enteroscope and the overtube, and are inflated and deflated
Results
Details of the approach, the type of enteroscopy (partial or total), the depth of endoscope advancement in centimeters, the preparation time required for the enteroscopy system, and the investigation time and radiation exposure are listed in Table 1. The first two patients with proven angiodysplasias were examined in collaboration with Yamamoto, who published the first description of the double-balloon enteroscopy technique (push-and-pull enteroscopy).11 Because the data for these two patients
Discussion
Attempts to carry out total enteroscopy by using the monorail or the ropeway technique and Sonde enteroscopy were abandoned at the end of the 1980s at the latest, and PE became the standard method for small-bowel enteroscopy.15 The advantages of PE over Sonde enteroscopy, as well as capsule endoscopy, are basically that it is possible to remove tissue and to carry out interventional procedures, e.g., hemostasis. However, only a limited section of the upper small bowel is accessible with PE.
Acknowledgments
We are grateful to Michael Robertson for translating and revising the manuscript.
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