Device-assisted enteroscopy: With increasing requirements, national Irish data support a centralized high-volume...

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Device Technology

Background:

• Device-assisted enteroscopy (DAE) demand is increasing globally.
• Variations in DAE practice and service provision may impact patient outcomes.
• The European Society of Gastrointestinal Endoscopy (ESGE) has established key performance indicators (KPIs) for DAE.

Purpose of the Study:

• To review Device-assisted enteroscopy (DAE) services in Ireland.
• To assess Irish DAE services against ESGE KPIs and broader outcome measures.
• To evaluate the impact of service provision on DAE outcomes in Ireland.

Main Methods:

• Retrospective collation of DAE data from Tallaght and Connolly Hospitals (January 2015 - May 2024).
• Inclusion of 941 DAE procedures, predominantly using double-balloon enteroscopy (DBE).
• Analysis of procedural details, including indication, depth of insertion, sedation, diagnostic yield, therapeutic interventions, and adverse events.

Main Results:

• Overall diagnostic yield was 63%, with therapeutic intervention in 41% of cases.
• Significant adverse events occurred in less than 1% of procedures.
• ESGE major KPIs were met, with high compliance for approved indications (94%) and adequate comfort (98%).
• Performance metrics were comparable to high-volume UK centers, outperforming lower-volume centers.
• Conscious sedation was used in 92% of cases with favorable outcomes and patient comfort.

Conclusions:

• High-volume DAE centers demonstrate compliance with international KPIs.
• Conscious sedation is a viable and effective option for most DAE procedures, maintaining patient comfort.
• Optimizing DAE service models is crucial for meeting increasing demand and ensuring quality patient care.