Motorized Spiral Enteroscopy Is Effective in Patients with Prior Abdominal Surgery

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Innovation

Background:

• Motorized Spiral Enteroscopy (MSE) enhances small bowel intubation depth and reduces procedure duration.
• Evidence on factors influencing MSE efficacy, particularly in patients with prior abdominal surgery, is limited.

Purpose of the Study:

• To assess the diagnostic yield and safety of MSE in patients with and without a history of major abdominal surgery.
• To identify factors affecting MSE performance, including depth of insertion and procedure time.

Main Methods:

• A prospective observational study involving 117 patients undergoing MSE between June 2019 and December 2021.
• Data collected included patient demographics, prior surgical history, procedure time, maximum insertion depth (DMI), technical success, diagnostic yield, and adverse events.

Main Results:

• Technical success rates were high (91.9% anterograde, 90.3% retrograde).
• Overall diagnostic yield was 71.6% anterograde and 61.3% retrograde.
• Patients with prior major abdominal surgery experienced longer insertion times (38 vs. 29 min) but similar diagnostic yield and DMI compared to controls.
• Those with prior gastrointestinal surgery had significantly lower DMI (189 cm) than those with other abdominal surgeries (374 cm).
• The overall adverse event rate was 10.3%, with no significant difference based on prior abdominal surgery.

Conclusions:

• MSE is a safe and effective endoscopic tool for evaluating the small bowel in patients with prior major abdominal surgery.
• While MSE demonstrates comparable diagnostic yield, longer procedure times and potentially reduced insertion depth in patients with a history of gastrointestinal surgery should be considered.