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Novel modified side-by-side balloon dilatation method for esophagogastric junction strictures: Single-/double-barrel
Akiko Toshimori1, Haruhiro Inoue1, Mary Raina Angeli Fujiyoshi1
1Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Summary
New endoscopic techniques allow for safe, gradual dilatation of gastrointestinal strictures up to 30mm under direct visualization. These methods improve treatment options for conditions like achalasia and post-surgical strictures.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Endoscopic balloon dilatation is standard for benign gastrointestinal strictures.
- Current commercial products struggle to achieve 20-30mm dilatations, and over 30mm under direct visualization is challenging.
- A need exists for innovative techniques to achieve larger dilatation widths safely.
Purpose of the Study:
- To develop and describe novel endoscopic methods for achieving greater than 20mm dilatation under direct visualization.
- To offer a safe and gradual approach for dilating gastrointestinal strictures requiring larger diameters.
Main Methods:
- Developed two modified endoscopic balloon dilatation methods: single-barrel and double-barrel.
- Single-barrel: Fixed balloon catheter to endoscope tip, released in stomach for retroflexed view, adjacent positioning at gastric cardia, gradual inflation.
- Double-barrel: Repeated procedure with two balloons, theoretically achieving >30mm dilatation.
Main Results:
- Successfully developed methods for achieving >20mm dilatation under direct endoscopic visualization.
- Theoretically achieved >30mm dilatation using the double-barrel method.
- Modified methods are adaptable for various dilatation widths by combining balloon sizes.
Conclusions:
- Simple, modified endoscopic techniques enable safe, gradual dilatation under direct visualization.
- These methods are potentially beneficial for esophagogastric junction strictures, including achalasia and post-Nissen fundoplication functional strictures.
- The described techniques offer a versatile approach to managing gastrointestinal strictures requiring significant dilatation.
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