Balloon-assisted enteroscopy using a single-balloon technique.
نویسندگان
چکیده
teroscopy system (Olympus Medical Systems Europa GmbH, Hamburg, Ger− many; l" Fig. 1) consists of a high−resolu− tion endoscope (XSIF−Q160Y) with a working length of 200 cm, and an outer diameter of 9.2 mm, and a flexible over− tube (XST−BY3A; l" Fig. 2) with a working length of 132 cm and an outer diameter of 13.2 mm. A latex−free balloon is only attached at the tip of the single−use sili− con overtube, and is inflated and deflated with air from a pressure−controlled pump system (Olympus balloon control unit MAJ−1440). The balloon on the tip of the overtube is deflated at the start of the procedure, un− til the duodenum is reached. The balloon is then inflated to maintain a stable posi− tion, and the enteroscope is inserted as far as possible. After this, the tip of the en− teroscope is angled (and hooked behind a fold if possible) to achieve a stable posi− tion of the distal tip. Now the overtube balloon is deflated and inserted along the enteroscope until the tip of the entero− scope is reached. The overtube balloon is then inflated again. At this position (l" Fig. 3) there are two options to further thread the endoscope into the small bowel: 1. Both the enteroscope and the overtube are pulled back in order to shrink the bowel. Following that, as an additional maneuver, the endoscope is once again threaded into the bowel. 2. The angulation is used to find the lumen of the bowel and then the over− tube is pulled back and simultaneous− ly the enteroscope is pushed forward into the lumen. In a two−examiner setting, this works best if one exami− ner is controlling the insertion tube plus overtube, and at the same time the other examiner controls the angu− lations in such a way that the distal tip always points into the free lumen. The two options for threading the over− tube into the small bowel can be com− bined. In comparison with enteroscopy using the double−balloon technique, this newly developed single−balloon enteros− copy seems to be easier to perform and saves time.
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عنوان ژورنال:
- Endoscopy
دوره 39 Suppl 1 شماره
صفحات -
تاریخ انتشار 2007