Prospective, randomised study proves double-balloon enteroscopy to be superior to newer single-balloon technique
Until recently, visualising the majority of the small bowel using non-surgical endoscopic techniques was an impossibility. The introduction of balloon enteroscopy – which in optimal cases enables the entire small bowel to be visualised – was therefore regarded as a decisive breakthrough in this field.
Double-balloon enteroscopy is now used universally in routine clinical practice for diagnostic and therapeutic small bowel examinations.
However, as Professor Christian Ell of the clinical centre Wiesbaden, teaching hospital of the University of Mainz in Germany explained at a press conference at the 18th United European Gastroenterology Week (UEGW) in Barcelona today, a simplified single-balloon enteroscope was recently introduced, prompting the initiation of the first randomised study comparing the two techniques.
Push-and-pull enteroscopy is another term used to describe balloon enteroscopy.
With the double-balloon technique, a high resolution video endoscope with a working length of around 2 metres is attached to a flexible overtube made of polyurethane. Latex balloons are attached at both the tip of the enteroscope and also on the overtube, and these can be inflated or deflated using a pressure-controlled pump.
With single-balloon enteroscopy, the balloon is attached to the tip of the overtube and, when the balloon is inflated, the overtube is anchored within the intestine allowing the endoscope to be advanced further.
“Complete enteroscopy was achieved with the double-balloon technique in 66% of patients compared with just 22% of patients who underwent single-balloon enteroscopy,” said Professor Ell.
“This means that three times more patients had their small bowel fully visualised with the older technique than with the newer one.”
By C. Musah