![]() ![]() The only difference in use is that in DBE the endoscope tip does not “hook” tissue, but instead the distal balloon inflates to anchor to the tissue before advancing the trailing balloon overtube (Fig. For double balloon enteroscopy (DBE), one balloon attaches to the end of the overtube and the other balloon attaches directly to the endoscope near the distal camera end. Ultimately, this push-pull maneuvering of the balloon overtube interfaced with the intestine allows a 2-m long endoscope to investigate a much longer length of small intestine. As the balloon overtube and endoscope sequentially advance, the small intestine effectively pleats over the overtube and endoscope. The endoscope tip then actuates to “hook” the tissue so that the balloon overtube can advance forward again after balloon deflation. The balloon overtube is then pulled backwards as the endoscope is advanced further. The balloon overtube is then advanced to this distal point and the balloon is inflated, anchoring it against the intestinal wall. After intubation, the endoscope is operatively advanced as far as possible. ![]() The endoscope extends through the overtube and the two slide freely against each other. For single balloon enteroscopy, the balloon is attached to the end of the overtube. The balloon enteroscopy system includes an endoscope, balloon overtube, and pressure control unit for balloon inflation and deflation. Balloon enteroscopy is also less invasive than surgical access (Yamamoto et al., 2014). It is also interventional unlike capsule enteroscopy, which can visualize the entire small intestine but cannot provide therapy or biopsy (Ciuti et al., 2016). Balloon enteroscopy allows the gastroenterologist to investigate more of the gastrointestinal tract than traditional “push” or direct enteroscopy. In balloon enteroscopy procedures, any portion of the small intestine can be visualized by plicating and compressing the small intestine on the overtube, allowing endoscopic interventions to be performed such as dilation, stenting, hemostasis, polypectomy, biopsy, ablation, and resection (Yamamoto et al., 2014). Second, the small intestine is approximately 6 m long and often tortuous whereas a traditional endoscope is less than 2 m long. First, the small intestine can only be reached endoscopically by navigating through the colon (rectal route) or the esophagus and stomach (oral route). The small intestine is difficult to navigate using typical endoscopes for two reasons. This work demonstrates both a method to pattern curved surfaces and that a balloon with patterned features improves anchoring against a deformable, lubricated tissue interface.īalloon-assisted enteroscopy is used to diagnose and treat small intestinal diseases including ulcers, obstruction, occult bleeding, and other abnormalities. Smooth latex balloons, used for standard enteroscopy, have the lowest peak force. ![]() Stiffer materials, low aspect-ratio features, and pattern area/location on the balloons significantly increase peak force compared to smooth silicone balloons. The anchoring ability of smooth versus balloons with patterned features is investigated by experimentally measuring a peak force required to induce slippage of an inflated balloon inside ex-vivo porcine small intestine. Here, the pattern design space is explored to determine factors that influence tissue anchoring. Patterning balloon exteriors with discrete features may enhance anchoring at the tissue-balloon interface. Enteroscopy balloons are pressure-limited to ensure patient safety and thus, improving anchoring without increasing pressure is essential. However, procedures are often prolonged or incomplete due to balloon slippage. This procedure can extend examination deeper into the small intestine than the length of the endoscope would allow with direct examination. These balloons anchor an endoscope and/or overtube to the small intestine, allowing endoscopists to plicate the small intestine over the overtube. Balloon-assisted enteroscopy procedures allow visualization and intervention in the small intestine. ![]()
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