Motorized spiral enteroscopy in clinical practice: Benefits and results in a single-center cohort study of 204 procedures

Objectives

The aim of this paper relies on our clinical experience in a single center with an evaluation of feasibility, clinical benefits, and safety in daily practice based on diagnosis and therapeutic yield using a newly designed Motorized Spiral Enteroscope (MSE) marked by Olympus.

Method

All examinations were conducted in the usual endoscopy suite with patients in the left lateral position with deep propofol sedation monitored by an anesthesiologist (bolus 2 ​mg/kg then 0.5 ​mg/kg on demand with mean total dose 300 ​mg (225.6–386 ​mg). For the anal route, MSE was performed on the X-ray table in order to monitor colonic passage and ileocecal intubation. Inflation was carried out with CO2 used.

Results

From June 2019 to July 2022, 204 procedures have been carried out. 188 patients were involved as repeated MSE was required due to multiple bleeding (male 111, 57.1%, female 87, 46.2%). In all cases, we considered a successful MSE when the enteroscope was deeply inserted in the ileum and achieved diagnosis or therapeutic indications as an endpoint (195 patients, 95.5%). Diagnostic yield was achieved in 134 procedures (65.7%).

Time to deep insertion was 11:36 ​± ​05.05 ​min, and the total procedure time was 22:07 ​± ​07:25 ​min. Minor mucosal damage occurred in 59 patients (28.9%).

Conclusions

In our 204 procedures MSE is a safe and useful new tool in routine clinical practice with an overall benefit for our patients.