Which Type of Deep Enteroscopy Procedure Is Best?

Summary and Comment |
July 17, 2017

Which Type of Deep Enteroscopy Procedure Is Best?

  1. Douglas G. Adler, MD, FACG, AGAF, FASGE

A meta-analysis suggests that balloon and spiral enteroscopy technologies have similar safety and efficacy.

  1. Douglas G. Adler, MD, FACG, AGAF, FASGE

Deep enteroscopy entered mainstream practice years ago, but there are several competing technologies available, including two types of balloon enteroscopy (BE) — single-balloon enteroscopy (SBE) and double-balloon enteroscopy (DBE) — and a third technique known as spiral enteroscopy (SE), all of which have their advantages and drawbacks.

In the current meta-analysis, researchers compared the efficacy and safety of BE and SE procedures. Eight studies including a total of 615 procedures were included. They found that diagnostic and therapeutic success rates were similar between BE and SE. Interestingly, the depth of maximal insertion was also similar between procedure types. SE procedures were shorter, and this difference was statistically significant.


Deep enteroscopy procedures are typically performed when capsule endoscopy shows a finding warranting an intervention. These procedures are often time-consuming and physically demanding on their operators. This study suggests a lack of meaningful differences between BE and SE, although the term BE encompasses both SBE and DBE, and limited data suggest that the depth of maximum insertion is greater with DBE compared with SBE. Many centers only have access to one form of deep enteroscopy technology based on their institutional purchasing contracts, so this study may not affect practice. However, it does suggest that all forms of deep enteroscopy are effective and safe. Spiral enteroscopy remains in very limited use at this time.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Dr. Adler is Professor of Medicine, Director of Therapeutic Endoscopy, and Program Director of the Gastroenterology Fellowship Program at the University of Utah School of Medicine, Salt Lake City.

Editor Disclosures at Time of Publication

  • Disclosures for Douglas G. Adler, MD, FACG, AGAF, FASGE at time of publication Consultant / Advisory board BSC; Merit Speaker’s bureau Abbvie Editorial boards Gastrointestinal Endoscopy Leadership positions in professional societies American College of Gastroenterology (Vice Chair, Board of Governors)


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