Double Balloon Enteroscopy | FAQ with Dr. Bull-Henry

Double Balloon Enteroscopy | FAQ with Dr. Bull-Henry


(suspenseful music)>>With enteroscopy, we
use a long flexible tube that we insert into the
mouth and it passes into the small bowel. Because the small bowel is so long, push enteroscopy, which
is what I just described, was very limited in its ability to go deep into the small bowel. And so, in 2001 in Japan, a
new technique was developed called double balloon enteroscopy. And with this technique, it uses a balloon and an overtube to be able
to advance more deeply into the small bowel and to
see areas of the small bowel that were previously inaccessible to us and this allows us to use
non-surgical techniques and treatments for large polyps and masses and to do biopsies of lesions
very deep in the small bowel. (suspenseful music) With double balloon enteroscopy,
it uses an interscope that has a flexible tube, an overtube, a flexible overtube with
it and it has a balloon at the end of the overtube and it has a balloon at the end of the interscope. And by using both of the
overtube and the balloon, we’re able to achieve very deep insertion into the small bowel. And the name, double balloon enteroscopy, actually comes from the two balloons that are used and that is one balloon at the tip of the overtube and one balloon at the tip of the interscope. The double balloon
enteroscopy is performed by alternately inflating the balloons at the end of the overtube and the balloon at the end of the interscope. By doing that and by pushing
and pulling the instrument, we’re able to pleat the small
bowel onto the overtube, and this shortens the
length of the small bowel and allows us to go deeper
into the small bowel. And if you think about
sewing, where you have fabric, that perhaps you’re trying
to gather onto elastic or if you have a curtain
rod and you’re trying to gather the curtain onto a rod, that is what we’re doing
with the small bowel. But ultimately, by repeating
these steps multiple times, we’re able to advance the
interscope and the overtube deep into the small bowel. Double balloon enteroscopy
can be performed via the upper GI tract through the mouth, which is called antegrade,
or it can be performed via the lower GI tract through the colon, which is called retrograde. In some patients, the entire
length of the small bowel can be evaluated by
combining both the antegrade and the retrograde procedures. The procedure can be
performed as an in-patient or in patients who are out-patients. The anesthesia used is
usually general anesthesia, but frequently, moderate
sedation can also be used depending on the clinical scenario. Sometimes the procedure is
performed with fluoroscopy or X-rays to help identify
the location of lesions. (suspenseful music) Double balloon enteroscopy
can help patients who have lesions very
deep in the small bowel. For instance, patients who have had video capsule
endoscopy, which has found bleeding lesions very
deep in the small bowel. Patients who have had other modalities, such as CT scans and a polyp or a mass or a worrisome lesion has been found. Or a patient who has had a stricture found on another modality. Or even a patient who has a foreign body or a retained video capsule,
double balloon enteroscopy can address all of those issues. In addition, for patients who have had surgically altered anatomy, such as a gastric bypass,
double balloon enteroscopy allows us to access the biliary system to perform, to remove
common bowelic stones or to place biliary stints as is needed. So, some patients may need colonoscopy and upper endoscopy before the
double balloon enteroscopy, but this is not always
necessary and depends on the clinical situation. (suspenseful music) With double balloon enteroscopy, we’re able to treat bleeding lesions, we’re able to dilate strictures, we’re able biopsy to masses,
we’re able to remove polyps, we’re able to remove foreign bodies, we’re able to remove common bowelic stones and to place biliary stints. This technology allows
us to offer patients a non-surgical treatment for many lesions that are found deep in the small bowel. (suspenseful music)

One thought on “Double Balloon Enteroscopy | FAQ with Dr. Bull-Henry

Leave a Reply

Your email address will not be published. Required fields are marked *