title: Initial experience with retrograde overtube-assisted enteroscopy using a spiral tip overtube.
abstract: Overtube-assisted enteroscopy has expanded therapeutic options for the small bowel, but the effectiveness of spiral tip overtube-assisted endoscopy for retrograde small bowel evaluation is not known. This retrospective study reviewed the results of retrograde enteroscopy procedures among six consecutive patients. In these patients, cecal retroflexion was necessary to enter the terminal ileum when using an enteroscope, and 40 to 130 cm of the distal small bowel was intubated. The average procedure time was 52 minutes. The procedure was diagnostic in four patients, and successful endoscopic therapy was performed in three patients, including completion of a polypectomy at the ileocecal valve, resolution of a distal intestinal obstruction in a patient with cystic fibrosis, and a small bowel anastomotic stricture release. There were no procedure-related complications. Overtube-assisted enteroscopy with the spiral tip overtube allows for antegrade or retrograde evaluation of the small bowel. Pan-enteroscopy may become possible as the technique and equipment improve. The advantages of the different forms of overtube-assisted enteroscopy (spiral, single, and double balloon) need to be determined.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Baylor University Medical Center (Lara); and Division of Digestive and Liver Diseases, Department of Internal Medicine, The University of Texas Southwestern Medical Center (Singh, Sreenarasimhaiah).
authors.forename: Luis F
authors.initials: LF
authors.lastname: Lara
authors.forename: Shailender
authors.initials: S
authors.lastname: Singh
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Sreenarasimhaiah
references.citation: World J Gastroenterol. 2005 Feb 21;11(7):1087-9
references.pmid: 15742422
references.citation: Gut. 2006 Sep;55(9):1372
references.pmid: 16905713
references.citation: Endoscopy. 2009;41 Suppl 2:E29-30
references.pmid: 19288410
references.citation: Endoscopy. 2009 Mar;41(3):194-9
references.pmid: 19280530
references.citation: Gastrointest Endosc. 2001 Feb;53(2):216-20
references.pmid: 11174299
references.citation: Dig Dis. 1996 Nov-Dec;14(6):345-55
references.pmid: 9030466
references.citation: Gastrointest Endosc. 2007 Sep;66(3 Suppl):S7-11
references.pmid: 17709038
references.citation: Gastrointest Endosc. 2008 May;67(6):890-7
references.pmid: 18178204
references.citation: Gastrointest Endosc. 1995 Feb;41(2):156-8
references.pmid: 7721006
references.citation: Am J Gastroenterol. 2006 Jul;101(7):1479-83
references.pmid: 16863549
references.citation: Endoscopy. 2005 Jul;37(7):613-6
references.pmid: 16010603
references.citation: Endoscopy. 2005 Jan;37(1):66-70
references.pmid: 15657861
references.citation: Gastrointest Endosc. 2006 Dec;64(6):1014-7
references.pmid: 17140921
references.citation: Gastrointest Endosc. 1996 Jun;43(6):631
references.pmid: 8781951
references.citation: Endoscopy. 2006 Jan;38(1):49-58
references.pmid: 16429355
references.citation: Endoscopy. 2005 Aug;37(8):745-50
references.pmid: 16032494
references.citation: Am J Gastroenterol. 2008 Oct;103(10):2656-7
references.pmid: 18855864
references.citation: Dig Dis Sci. 2008 Aug;53(8):2140-3
references.pmid: 18270840
references.citation: Gastrointest Endosc. 2005 Jul;62(1):62-70
references.pmid: 15990821
references.citation: Gastrointest Endosc. 2008 Dec;68(6):1112-6
references.pmid: 18599052
references.citation: Clin Gastroenterol Hepatol. 2004 Nov;2(11):1010-6
references.pmid: 15551254
references.citation: Eur J Gastroenterol Hepatol. 2007 Jul;19(7):529-34
references.pmid: 17556897
references.citation: Liver Transpl. 2005 Dec;11(12):1608-10
references.pmid: 16315301
references.citation: Gastrointest Endosc. 2009 Feb;69(2):333-6
references.pmid: 19185693
references.citation: Endoscopy. 2008 Sep;40 Suppl 2:E164
references.pmid: 18668453
references.citation: Endoscopy. 2008 Dec;40(12):974-8
references.pmid: 19065477
references.citation: Gastrointest Endosc Clin N Am. 2004 Jan;14(1):87-100
references.pmid: 15062383
references.citation: Gastrointest Endosc. 2007 Nov;66(5):872-80
references.pmid: 17904135
references.citation: Am J Gastroenterol. 2007 Mar;102(3):527-35
references.pmid: 17222315
references.citation: Gastrointest Endosc. 2009 Feb;69(2):327-32
references.pmid: 19100974