Technical advances and experimental devices for enteroscopy

Enteroscopy remains the procedure in the gastrointestinal tract that is most inaccessible to endoscopy, and technical limitations severely impair the ability to advance and examine the small bowel reliably or completely. Push-type enteroscopy not only suffers limitations owing to looping in the stomach, but is intrinsically associated with increasing loss of transmission of force to the tip and consequent failure of advancement. Development is this area has been slow, partly owing to the limited clinical need compared with upper gastrointestinal endoscopy, and colonoscopy and consequent financial limitations imposed on further development. Practical and useful technical advances have been made, especially in push-type as well as sonde-type enteroscopy. These are reviewed briefly and are covered in other articles elsewhere in this issue.