Gastroenterologie
a hepatologie

Double-balloon vs. motorized spiral enteroscopy: a single tertiary center experience

Přemysl Falt ^{Orcid.org  1}, Ondřej Urban¹

+ Affiliation
¹ II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc

Summary

Background: Deep enteroscopy is a method of choice in patients with suspected small intestine disease. In 2023, motorized spiral enteroscopy (PSE – powerspiral enteroscopy) has been withdrawn by the manufacturer due to safety reasons. The aim of our study was to compare cases examined by PSE to cases examined by double-balloon enteroscopy (DBE) that has replaced PSE. Methods: We did a comparison of prospectively analyzed consecutive patients examined by PSE from June 2019 to June 2022 with restrospectively analyzed consecutive patients examined by DBE from September 2023 to February 2025. Main outcomes were technical success rate, diagnostic yield, success rate of total enteroscopy, and complication rate. Results: A total of 82 PSE in 62 patients had been performed (56% male, age 58 ± 18 years) and a total of 37 DBE examinations in 29 patients were performed (41% male, age 57 ± 19 years). Technical success rate (94 vs. 95%), diagnostic yield (81 vs. 90%), success rate of total enteroscopy, if indicated (84 vs. 75%), and complication rate (2 vs. 3%) were compared. Insertion times were longer while performing DBE. Conclusion: In our single-center comparison, PSE and DBE showed similar procedural characteristics and concurrently, specific differences arising from different mechanisms of insertion. DBE was able to fully replace PSE after its withdrawal.

Keywords

powerspiral enteroscopy, double-balloon enteroscopy, small intestine

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Literature

1. Pennazio M, Spada C, Eliakim R et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2015; 47(4): 352–376. doi: 10.1055/s-0034-1391855.
2. Recall – Market removal of PowerSpiral PSF-1 and associated accessories DPST-1 and PSCU [IT2081382+FSN-QIL+FY24-EMEA-10-FY24-OMSC-05+Olympus+Medical+Systems+Corporation+PowerSpiral+Intestinal+Videoscope+PSF-1%20].
3. Falt P, Urban O. Motorized spiral enteroscopy – a prospective analysis of 82 procedures at a single tertiary center. Scand J Gastroenterol 2023; 58(10): 1207–1212. doi: 10.1080/00365521.2023.2212311.
4. Nass KJ, Zwager LW, van der Vlugt M et al. Novel classification for adverse events in GI endoscopy: the AGREE classification. Gastrointest Endosc 2022; 95(6): 1078.e8–1085.e8. doi: 10.1016/j.gie.2021.11.038.
5. Yamamoto H, Despott EJ, Gonzalez-Suarez B et al. The evolving role of device-assisted enteroscopy: the state of the art as of August 2023. Best Pract Res Clin Gastroenterol 2023; 64–65: 101858. doi: 10.1016/j.bpg.2023.101858.
6. Lu Z, Qi Y, Weng J et al. Efficacy and safety of single-balloon versus double-balloon enteroscopy: a single-center retrospective analysis. Med Sci Monit 2017; 23: 1933–1939. doi: 10.12659/msm.900343.
7. Koh JTE, Wei LK, Francisco CP et al. Double balloon enteroscopy versus single balloon enteroscopy: a comparative study. Medicine (Baltimore) 2024; 103(20): e38119. doi: 10.1097/MD.0000000000038119.
8. Wadhwa V, Sethi S, Tewani S et al. A meta-analysis on efficacy and safety: single-balloon vs. double-balloon enteroscopy. Gastroenterol Rep (Oxf) 2015; 3(2): 148–155. doi: 10.1093/gastro/gov003.
9. De Koning M, Moreels TG. Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery. BMC Gastroenterol 2016; 16(1): 98. doi: 10.1186/s12876-016-0512-6.
10. Takano N, Yamada A, Watabe H et al. Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011; 73(4): 734–739. doi: 10.1016/j.gie.2010.10.047.
11. Yamamoto H, Sekine Y, Sato Y et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001; 53(2): 216–220. doi: 10.1067/mge.2001.112181.
12. Yin A, Hu W, Zhao L et al. Diagnosis and therapy using double-balloon endoscopy for small bowel disease: experience from a Chinese tertiary hospital. J Int Med Res 2020; 48(10): 300060520959489. doi: 10.1177/03000 60520959489.
13. Kopacova M, Rejchrt S, Tacheci I et al. Hyperamylasemia of uncertain significance associated with oral double-balloon enteroscopy. Gastrointest Endosc 2007; 66(6): 1133–1138. doi: 10.1016/j.gie.2007.03.1085.
14. Neuhaus H, Beyna T, Schneider M et al. Novel motorized spiral enteroscopy: first clinical case. VideoGIE 2016; 1(2): 32–33. doi: 10.1016/j.vgie.2016.08.005.
15. Beyna T, Arvanitakis M, Schneider M et al. Motorised spiral enteroscopy: first prospective clinical feasibility study. Gut 2021; 70(2): 261–267. doi: 10.1136/gutjnl-2019-319908.
16. Beyna T, Arvanitakis M, Schneider M et al. Total motorized spiral enteroscopy: first prospective clinical feasibility trial. Gastrointest Endosc 2021; 93(6): 1362–1370. doi: 10.1016/j.gie.2020.10.028.
17. Beyna T, Schneider M, Pullmann D et al. Motorized spiral colonoscopy: a first single-center feasibility trial. Endoscopy 2018; 50(5): 518–523. doi: 10.1055/s-0043-123577.
18. Kopacova M, Tacheci I, Rejchrt S et al. Double balloon enteroscopy and acute pancreatitis. World J Gastroenterol 2010; 16(19): 2331–2340. doi: 10.3748/wjg.v16.i19.2331.
19. Chaze I, Gincul R, Lepilliez V et al. Gastroesophageal intussusception and multivisceral failure after per oral spiral enteroscopy. Video J Encycloped GI Endoscop 2013; 1(1): 230–232. doi: 10.1016/S2212-0971(13)70098-0.