Device-assisted enteroscopy: Are we ready to dismiss the spiral?

Area of Science:

• Gastroenterology
• Endoscopy

Background:

• Motorized spiral enteroscopy (MSE) is an advanced enteroscopy technique.
• Previous studies compared MSE adverse events with balloon enteroscopy.
• An unexpected esophageal injury issue led to MSE's market withdrawal.

Purpose of the Study:

• To evaluate the diagnostic and therapeutic performance of MSE in real-life clinical practice.
• To assess the safety of MSE during its early introduction phase.
• To explore MSE's potential as a rescue procedure after failed balloon enteroscopy.

Main Methods:

• An Italian multicenter prospective study was conducted.
• The study was prematurely terminated due to MSE market withdrawal.
• A subanalysis focused on patients who underwent MSE after unsuccessful balloon enteroscopy.

Main Results:

• MSE demonstrated encouraging diagnostic and therapeutic yield.
• A subanalysis revealed promising performance of MSE as a rescue technique.
• Despite safety concerns, MSE showed potential in clinical practice.

Conclusions:

• MSE exhibited remarkable performance, particularly as a backup technique.
• Refining and enhancing MSE may be more appropriate than complete abandonment.
• Further development could address safety issues and leverage MSE's potential.