BACKGROUND AND STUDY AIMS: Data are scarce on the efficacy and safety of the Motorized spiral enteroscopy (MSE). No data are available on the utility of this technique in patients with surgically-altered gastrointestinal (GI) anatomy. We aimed to evaluate the safety and efficacy of MSE in patients with suspected small-bowel disease including those with surgically-altered GI anatomy. METHODS: A multicenter prospective observational, uncontrolled study evaluated MSE in consecutive patients with suspected small-bowel pathology indicated for diagnostic and/or therapeutic intervention. RESULTS: A total of 170 patients (median age, 64 years; range 18-89 years; 102 male, 68 female) were included. The overall diagnostic yield was 64.1%. Endotherapy was performed in 53.5% of procedures. The median total procedure time for antegrade and retrograde approach was 45 minutes (IQR=30-80) and 40 (IQR=30-70) respectively. When total (pan-)enteroscopy was intended, this was achieved at rate of 70.3%, (28.1% by antegrade approach and 42.1% by a bi-directional approach). Surgically-altered GI anatomy was present in 34/170 (20%) of the all procedures and in 11/45 (24.4%) of the successful total enteroscopy procedures. Propofol sedation or general anesthesia were used in 92.9% and 7% of the procedures respectively. Minor adverse events were observed in 15.8% of patients, but no major adverse events. CONCLUSION: MSE seems to be effective and safe endoscopic procedure. Total (pan-)enteroscopy can be achieved, in one or two sessions, even in the presence of surgically-altered GI anatomy. The total procedure time is relatively short. For both antegrade and retrograde MSE procedures, propofol sedation seems sufficient and safe.

Background and aims A significant percentage of colonoscopies remain incomplete because of failure to intubate the cecum. The motorized spiral enteroscope (MSE) technique, originally developed for deep small bowel enteroscopy, may be an effective alternative technique in cases of incomplete examination of abnormally long colons (dolichocolon). We prospectively evaluated the success rate of cecal intubation, safety and the therapeutic consequences of using MSE after incomplete conventional colonoscopy. Methods A total of 36 consecutive patients with an indication for diagnostic and/or therapeutic colonoscopy were prospectively enrolled in this multicenter trial. All patients had undergone at least one incomplete colonoscopy attributed to abnormally long colons. Patients with incomplete colonoscopy due to stenosis were excluded. Results Twenty-two men and 14 women (median age 66 years, range 35-82) were enrolled. Median procedure time was 30 min (range 16-50). Cecal intubation rate was 100% and median cecal intubation time was 10 min (range 4-30). Abnormalities, mostly neoplastic lesions, were detected in 23 of 36 patients, corresponding to a diagnostic yield of 64%. All these findings were in the right side of the colon and had not been described by the antecedent incomplete coloscopy. No adverse events occurred. Conclusion In case of a difficult and long colon, MSE is safe and effective for diagnostic and therapeutic colonoscopy. It may provide an attractive solution to accomplish completeness of previous incomplete colonoscopies in these patients.