Advances and applications of enteroscopy for small bowel.

Abstract

Visual inspection of the entire small intestine is difficult and time-consuming, due to its anatomical location. While the usual techniques of endoscopy facilitate visualization of the most proximal and distal ends of the gut, only limited views of the terminal ileum (only about 5 cm to 25 cm) can be obtained by intubation of the ileocecal valve after total colonoscopy. The proximal jejunal mucosa (20 cm to 50 cm) can be inspected by standard colonoscopy or use of related modified instrumentation. Therefore, investigation of this region is dependent upon enteroclysis and angiography. The diagnostic efficacy of these procedures, however, is relatively low, and confirmative diagnosis has frequently been made only after laparotomy. Achievement of successful endoscopy for other parts of the gastrointestinal tract has allowed for further improvements to the enteroscopy technique. Since the 1970s, vigorous efforts have been made to produce three types of enteroscopes, namely the push type, sonde type, and ropeway type. The recent development of video endoscopes, including a new prototype video enteroscope for small bowel, has benefited clinical practice. In this paper, we describe the recent advances in enteroscopy, including its devices and applications.