Single-Balloon Assisted Deep Enteroscopy

Single balloon assisted enteroscopy (SBE) is an examination of the lining of the esophagus, stomach, and deep small intestine (duodenum, jejunum and ileum) with a small camera (flexible endoscope) which is inserted down the throat with the assistance of an overtube/balloon system (see image). On the tip of the overtube is a balloon that can be blown up and deflated. The balloon when blown up is used to anchor the overtube within the intestine. While the overtube is anchored, the endoscope can be advance further into the small intestine. By withdrawing the overtube the small intestine can be shortened and straightened to make the passage of the inner endoscope easier. The balloon may then be deflated so that the overtube can be inserted further and the endoscope advanced again. The endoscope itself is a longer than the standard endoscope (200 cm or 8 feet) with working channels that allow the intestine to be inflated with air, rinsed with water, or to guide biopsy or electrocautery instruments to the tip of the endoscope. The procedure is pain free as you will receive a sedative and pain medications to ensure your comfort. A local anesthetic may be sprayed into your mouth to suppress the cough or gag reflex when the endoscope is inserted. A mouth guard will be inserted to further protect your teeth and the endoscope during the proocedure.

 

Your physician may ask you to stop certain medications before your procedure. Otherwise, the only preparation for the procedure is a period of fasting ranging from 8-10 hours prior to the procedure.

 

SBE is safe.  The risks associated with the procedure are commonly related to sedation such as transient respiratory depression (slowness of breathing) and minor change in vital signs (blood pressure and heart rate).

 

Risks of SBE are similar and slightly higher than a standard upper endoscopy due to insertion depth and prolonged procedure time. Infection is extremely uncommon with diagnostic SBE (1-5 per 10 million); perforation (tear) risk is 3 per 10,000, and risk of death is 1 per 100,000 (the risk of randomly being shot at is 6 in 100,000). Bleeding risk from diagnostic SBE is extremely rare. These risks are increased with interventions such as biopsies (sampling), dilation (stretching of tight spots), cautery and others.

 

When you wake up, you may feel a little bloated from the air that is introduced through the endoscope, but this will wear off in a short period of time.