Validity of insertion depth measurement in double-balloon endoscopy

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Innovation

Background:

• Double-balloon enteroscopy (DBE) requires reliable methods for calculating endoscope insertion depth.
• Accurate depth measurement can enhance diagnostic accuracy and optimize procedural efficiency and cost.

Purpose of the Study:

• To compare and evaluate two distinct methods for estimating insertion depth during DBE.
• To develop a descriptive model for DBE exploration dynamics, analyzing advanced distance and time.

Main Methods:

• Oral DBE was conducted on 25 pigs.
• Insertion depth was estimated using time/distance per push-pull cycle during advancement and distance during withdrawal.
• Post-necropsy measurements were compared to in-vivo estimations.

Main Results:

• Average insertion depths were 324.92 cm (progression), 317.23 cm (withdrawal), and 342.05 cm (necropsy).
• High agreement was observed between progression and necropsy (0.03% difference) and withdrawal and necropsy (6.9% difference).
• Exploration dynamics and efficiency were modeled using potential and logarithmic regression, respectively.

Conclusions:

• In-vivo measurement of insertion depth during DBE was validated in a porcine model.
• Estimation during progression was more accurate and provided data for modeling exploration dynamics.
• These findings may serve as approximate reference values for human DBE procedures.