Mo1613 CAP-Assisted Retrograde Single Balloon Enteroscopy Results in High Terminal Ileal Intubation Rate

Abstract

Retrograde single-balloon enteroscopy (RSBE) is an established modality for diagnosis and treatment of distal small bowel lesions that are beyond the reach of standard ileocolonoscopy. However, it is a challenging and complicated procedure requiring significant time and skill beyond standard endoscopy. A major barrier to retrograde enteroscopy is intubation of the terminal ileum (TI), with failure rates documented as high as 30% [1]. This is due to the lack of stiffness in the relatively small-caliber enteroscope, which often results in looping of the instrument when trying to intubate the TI. Cap-assisted endoscopy has previously proven beneficial for several aspects of endoscopy, including cecal intubation, adenoma detection, and visualization of the ampulla of Vater by peeling away mucosal folds [2–4]. Similarly, we have found that a distal cap aids in many aspects of retrograde balloon enteroscopy, including intubation of the TI, by facilitating opening of the ileocecal valve (ICV). Therefore, we set out to determine the terminal ileal intubation rate during RSBE while utilizing a distal cap, as well as procedural outcome variables.