MOTORIZED SPIRAL ENTEROSCOPY: A SINGLE-CENTER EXPERIENCE

Aims Motorized spiral enteroscopy (PowerSpiral Olympus) is a novel technique for small bowel exploration. The aim of this study is to describe this new technique and demonstrate its advantages in terms of facility and depth in insertion, short procedure time and stability at withdrawal in patients with obscure gastrointestinal bleeding and suspected small bowel lesions on capsule endoscopy. It’s a new tool modified from the manual spiral technique.

Methods Patients with suspected small bowel lesion diagnosed by capsule endoscopy were prospectively included between June 2019 and october 2019 in our endoscopy unit.

Results After capsule endoscopy, 24 motorized spiral enteroscopy were performed. In two of the performed cases there was a difficulty in passing the spires through the esophagus and one of them was successfully accomplished after esophageal dilation. Overall, 22 exams were performed with excellent tolerance under general anesthesia. All indications except one (21/22) were obscure gastrointestinal bleeding. Lesions detected by capsule endoscopy were mainly angioectasia (77%). Motorized spiral enteroscopy resulted in finding one or more lesions in 72% of cases. The mean procedure time was 27 min (16-37) and in 72 % (16/22) of cases deep part of ileum was reached. Treatment during the procedure was possible (APC or clips) in all the cases where lesions were identified. Minor complications such as mucosal superficial lacerations mainly in the esophagus and the pylorus were present in 45% (10/22) of cases and there was no major procedure-related complication.

Conclusions Motorized spiral enteroscopy in an alternative technique for diagnostic and therapeutic small bowel enteroscopy. It appears to have some advantages, but further large controlled trials are needed in order to verify the efficiency of this device.