Training in Endoscopy: Enteroscopy

Abstract

The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing. Recent studies have been focused on the diagnostic yield, therapeutic yield, and long-term outcomes of the device. However, with the increasing number of procedures, procedural guidelines and quality indicators are also needed.

Atypical Presentation of Gastric Cancer Approached Via Retrograde Single Balloon Enteroscopy

“…The long, flexible endoscope (200 cm or 8 feet) goes deep into the small bowel and has an over-tube with a balloon at the tip. Repeated push and pull of the over-tube helps in reducing the loops of the small bowel, thus pleating the small bowel on the tube [ 10 ].…”

Motorized Spiral Enteroscopy for Occult Bleeding

“…The device was inserted and advanced with the assistance of motorized clockwise spiral rotation. The maximal depth of insertion was 2 m in the small bowel (estimated by fold-counting method [7]) with a time of progression of 30 min. Two angiodysplasias were visualized during the progression and treated by argon plasma coagulation.…”

Enteroscopy in children

“…Radiology is also useful to assess stricture complexity and to guide balloon dilation. 21 Currently, there are not specific and well-established learning programmes for enteroscopy, especially for paediatric endoscopists. 15 Enteroscopy training may be incorporated into the standard endoscopic training.…”