title: A prospective comparison of performance during back-to-back, anterograde manual spiral enteroscopy and double-balloon enteroscopy.
abstract: BACKGROUND
  Spiral enteroscopy is a recently introduced technology alternative to balloon-assisted enteroscopy for examination of the small bowel.
  
  
  OBJECTIVE
  To compare small bowel insertion depths and procedure duration by spiral enteroscopy and double-balloon enteroscopy performed in the same cohort of patients, in immediate succession, using the same method of insertion depth estimation.
  
  
  METHODS
  A prospective, back-to-back comparative study was performed in 15 patients. Spiral enteroscopy procedures were performed first and a tattoo was placed to mark the most distal point.
  
  
  RESULTS
  Double-balloon enteroscopy passed the tattoo placed at spiral enteroscopy in 14/15 cases (93%). Median insertion depths for double-balloon enteroscopy and spiral enteroscopy were 265cm and 175cm, respectively (P=0.004). Median time to achieve maximal depth of insertion was significantly shorter for spiral enteroscopy compared with double-balloon enteroscopy (24min vs. 45min, respectively; P=0.0005). However, in 14 patients no differences were found in median time to reach the same insertion depth (P=0.28).
  
  
  CONCLUSIONS
  Double-balloon enteroscopy achieved significantly greater small bowel insertion depth than spiral enteroscopy. Although overall double-balloon enteroscopy procedure duration was longer, the time taken to reach the same small bowel insertion depth by both spiral enteroscopy and double-balloon enteroscopy was similar.
authors: Royal Free Unit for Endoscopy and Centre for Gastroenterology, UCL Institute for Liver and Digestive Health, Royal Free NHS Foundation Trust, London, United Kingdom; Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, United Kingdom. Electronic address: edespott@doctors.org.uk.
authors: Edward J
authors: EJ
authors: Despott
authors: Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, United Kingdom.
authors: Alberto
authors: A
authors: Murino
authors: Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, United Kingdom.
authors: Leonidas
authors: L
authors: Bourikas
authors: Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, United Kingdom.
authors: Masanao
authors: M
authors: Nakamura
authors: Department of Anesthesia and Intensive Care, North West London Hospitals NHS Trust, United Kingdom.
authors: Vino
authors: V
authors: Ramachandra
authors: Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, Imperial College London, United Kingdom.
authors: Chris
authors: C
authors: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D058582:Double-Balloon Enteroscopy / Q000295:instrumentation / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013996:Time and Motion Studies
keywords: Depth of insertion; Device assisted enteroscopy; Enteroscopy; Small bowel