Double and Simple Balloon Enteroscopy

The double-balloon enteroscopy is a special endoscopic procedure designed for the thorough examination of the small intestine. This method allows specialists to examine several meters of bowel segments, thereby assisting in diagnosis and identifying various bowel diseases.

The technique is based on a special, long, and thin endoscope, which includes a sheath, also known as an overtube. Together, they form the double-balloon system, which is available in various sizes, but the most common version is 2000 mm long and 9.4 mm in diameter. The inflatable balloons at the end of the endoscope are intended to stabilize the instrument within the small intestine, ensuring an effective and safe examination.

During the examination, the specialist secures the sheath equipped with the inflated balloon within the bowel, then advances the enteroscope forward. Once the desired location is reached, the inflation of the balloon at the end follows, which secures its position while the sheath balloon is deflated. The sheath balloon is then inflated, and the two are carefully withdrawn together, shortening the instrument. This technique is extremely important because stabilizing the small intestine allows for proper examination while also reducing the length of the endoscope.

The process of double-balloon enteroscopy

In double-balloon enteroscopy, the procedure begins with the endoscope passing through the esophagus and stomach into the duodenum, as far into the small intestine as possible. Insufflation of air is essential, but it is important to do this to the least extent possible, as an overly inflated stomach can hinder the examination. The goal is for the instrument to move smoothly forward in the small intestine, where specialists can thoroughly examine the various bowel segments during the examination.

The double-balloon system allows specialists to examine several meters of small intestine by shortening the bowel and repeating the worm-like movement. This technique can be particularly useful in diagnosing inflammatory bowel diseases, tumors, or other pathologies.

During the procedure, specialists continuously monitor the patient’s condition and respond immediately to any discomfort or problematic signals during the examination. To ensure comfort during the endoscopy and appropriate pain relief, sedation or anesthesia is typically used in most cases.

Single-balloon enteroscopy

Single-balloon enteroscopy is a modified version of double-balloon enteroscopy that offers certain advantages. The fundamental difference between the two methods is that while the double-balloon system uses inflatable balloons at both ends, the single-balloon version has a balloon only at the end of the sheath. In this case, the enteroscope is secured by bending the steerable tip, allowing it to be drawn into the bowel loop.

This method offers a simplified approach compared to double-balloon enteroscopy, which also allows for a thorough examination of the small intestine. During the procedure, specialists perform bowel shortening and advancement similarly to the double-balloon method.

Despite the differences, both techniques aim to thoroughly inspect the small intestine, and the choice depends on the patient’s condition and the area being examined. Single-balloon enteroscopy provides an opportunity for specialists to perform the examination effectively with fewer instruments.