| Theme | Therapeutic Colonoscopy -- Recent Advances | |
|---|---|---|
| Title | Endoscopic Colon Treatment Using Double-Balloon Endoscopy | |
| Publish Date | 2005/12 | |
| Author | Tomonori Yano | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hironori Yamamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Hiroto Kita | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Keijiro Sunada | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Tomohiko Miyata | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| Author | Michiko Iwamoto | Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School |
| [ Summary ] | Double-balloon endoscopy uses 2 balloons, one attached to the tip of the endoscope and another at the distal end of an overtube. By using these balloons to grip the intestinal wall, the endoscope can be inserted further without forming redundant loops in the intestine. The main reason for difficulty with endoscope insertion is not the curvature of the intestine itself, but the extension of the bent intestine. We have therefore devised a technique to prevent intestinal extension by holding it with a balloon attached to the distal end of a soft overtube. As long as this overtube prevents intestinal extension, the distal end of the endoscope can be advanced by inserting it through the overtube, even if the intestine is curved to some extent. In many cases of unsuccessful colonoscopy, the endoscope cannot be straightened because the loop in the sigmoid colon or the curvature of the transverse colon cannot be overcome, due to adhesions or other reasons ; even in such cases, our method enables deeper insertion of the endoscope by holding the intestine with the minimum amount curvature. This technique provides a stabilized maneuver without paradoxical movement. Therefore, this is useful to perform endoscopic therapies such as polypectomies, endoscopic mucosal resection, and endoscopic submucosal dissection in a difficult portions of the colon. |
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