Double-balloon is equal to motorized spiral enteroscopy in a German prospective, randomized trial

Deep enteroscopy is a challenging and time-consuming procedure. Two devices have become the clinical standards for patients: double-balloon enteroscopy (DBE) and motorized spiral enteroscopy (mSPE). Initially, mSPE demonstrated impressive results, with high rates of total enteroscopy, which were superior to those of all other devices. However, for safety reasons, mSPE was withdrawn from the market, and it remains uncertain whether it will return after technical improvements. This prospective randomized trial aimed to compare the DBE and mSPE.

Patients indicated for enteroscopy were randomized to undergo either mSPE or DBE. The time to diagnosis or complete enteroscopy was measured, and all complications were recorded.

A total of 48 enteroscopic procedures were performed, including 23 mSPE and 25 DBE. No significant difference was noted in the procedure time (p=0.212). The mSPE group exhibited a shorter mean procedure time of 54 (range, 15-114; standard deviation [SD], 26) minutes, whereas the DBE group had a mean procedure time of 63 (range, 20-131; SD, 25) minutes. One perforation was seen in the mSPE group.

DBE and mSPE are both effective enteroscopy methods but showed no significant difference in this randomized trial (German trial registry: DRKS 00025890).