Motorized spiral enteroscopy: effectiveness when used for new indications

Colin, Henri; Donati, Abele; Monino, Laurent; Moreels, Tom G.

doi:10.51821/86.2.11779

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…As a safety measure, the motor stops automatically when the overtube encounters too much friction. Despite early enthusiasm for this device allowing unidirectional panenteroscopy in a timely manner, outclassing other device-assisted enteroscopy systems, recent reports stated that they should be considered as complementary instead of competitive enteroscopy systems (3)(4)(5). The drop that broke the camel's back appeared to be the death of a patient with a blocked overtube inside the oesophagus.…”

Section: To the Editormentioning

confidence: 99%

“…Instead of throwing the baby out with the bathwater, MSE merits further development and improvement, based on the positive outcomes of recent single-and multi-centre publications (3,5). Apart from insufficient practical MSE training under supervision, specific endoscope design features may also explain the current efficacy and safety concerns.…”

Section: To the Editormentioning

confidence: 99%

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Motorized spiral enteroscopy: this is the end my friend?

Moreels

2024

AGEB

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Endoscopic devices have a history of being launched as the next big thing, and subsequently being retrieved from the marked because of efficacy or safety concerns. The Shapelock overtube to overcome sigmoid loop formation during colonoscopy and the Enteryx implant to reduce gastro-oesophageal reflux are only two examples (1,2). They were voluntarily removed by the manufacturers because of serious adverse events. These were accessory devices to facilitate endoscopy or to perform endoscopic therapeutic interventions.

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Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

Motorized spiral enteroscopy: this is the end my friend?

Moreels

2024

AGEB

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Enteroscopy-assisted ERCP in patients with surgically altered anatomy: Multicenter prospective registry (SAMISEN-B) using motorized spiral enteroscopy

Moreels,

Aabakken,

Arvanitakis

et al. 2024

Endosc Int Open

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BACKGROUND & STUDY AIMS: Prospective study of efficacy and safety of Motorized Spiral Enteroscopy (MSE) to perform biliary endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy at 5 European centers. PATIENTS & METHODS: Consecutive patients with biliary indications for enteroscopy-assisted ERCP. Objectives were technical success, adverse event rate and patient radiation exposure. RESULTS: 89 patients were enrolled, 1 pancreatic indication excluded, all with variations of Billroth II reconstruction (29.5%) or Roux-en-Y reconstruction (70.5%), either with naive papilla (39%) or hepaticojejunostomy (61%). Main indications were anastomotic stricture treatment and/or biliary stone removal. Enteroscopy to reach the bile duct was possible in 65/88 patients (74%), bile duct cannulation in 54/88 (61%) and therapeutic ERCP was technically successful in 48/88 (54%). In Billroth II variations technical success was achieved in 13/26 (50%) compared to 35/62 (57%, p=0.5792 Chi square) in Roux-en-Y reconstructions (including bariatric gastric bypass). ERCP with intact papilla was successful in 17/34 (50%) compared to 31/54 (57%, p=0.4968 Chi square) in hepaticojejunostomy. In July 2023 the study was prematurely terminated since MSE was withdrawn by the manufacturer because of safety issues. Overall, in 12/88 (14%) patients adverse events (AE) were recorded and 6 (7%) were considered serious. Only 1 SAE was attributable to MSE enteroscopy: perforation of the proximal oesophagus during enteroscope insertion. CONCLUSIONS: This prospective multicenter study was prematurely discontinued due to withdrawal of the MSE by the manufacturer because of safety issues. Technical success of MSE-assisted biliary ERCP in different types of surgically altered anatomy was 54%, which was lower than anticipated. There was one oesophageal perforation attributable to the use of MSE. (clinicaltrials.gov: NCT05129449)

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Motorized spiral enteroscopy: A cautious step forward in technological innovation

Xiao,

Lin,

Chen

2024

World J Gastrointest Endosc

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With the continuous advancement in medical technology, endoscopy has gained significant attention as a crucial diagnostic tool. The introduction of motorized spiral enteroscopy (MSE) represents a significant advancement in the diagnosis and treatment of small bowel diseases. While there are safety concerns and a high reliance on the operator’s skills, MSE should not be disregarded entirely. Instead, it should be considered as a supplementary endoscopic technique, particularly in situations where conventional endoscopy proves ineffective. Through continuous research and technical optimization, MSE has the potential to become an important addition to the endoscopy toolbox in the future. We call on colleagues in the industry to work together to promote the improvement of MSE technology through continuous research and practice, with the aim to bring out its unique value in endoscopy while ensuring patient safety.

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Motorized spiral enteroscopy: effectiveness when used for new indications

Cited by 3 publications

References 16 publications

Motorized spiral enteroscopy: this is the end my friend?

Motorized spiral enteroscopy: this is the end my friend?

Enteroscopy-assisted ERCP in patients with surgically altered anatomy: Multicenter prospective registry (SAMISEN-B) using motorized spiral enteroscopy

Motorized spiral enteroscopy: A cautious step forward in technological innovation

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