Within the last decade, the technological development improved the diagnostic work-up of small bowel diseases. In addition to abdominal ultrasound and radiological methods, the importance of endoscopy is increasing. Nowadays, five nonsurgical flexible endoscopy techniques are available for small bowel endoscopy: push enteroscopy and balloon-guided enteroscopy for evaluation of the proximal small bowel, balloon-assisted enteroscopy using two balloons (double-balloon enteroscopy) or one balloon (single-balloon enteroscopy), and spiral enteroscopy for evaluation of the deep small bowel. Intraoperative enteroscopy has become a reserve method.

Keywords:
Double-balloon enteroscopy, Single-balloon enteroscopy , Balloon-assisted enteroscopy, Spiral enteroscopy, Small bowel endoscopy
1.
May A, Nachbar L, Schneider M, et al: Prospective comparison of push enteroscopy and push-and-pull enteroscopy in patients with suspected small-bowel bleeding. Am J Gastroenterol 2006;101:2016-2024.
2.
Yamamoto H, Sekine Y, Sato Y, et al: Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001;53:216-220.
3.
May A, Nachbar L, Wardak A, et al: Double-balloon enteroscopy: preliminary experience in patients with obscure gastrointestinal bleeding or chronic abdominal pain. Endoscopy 2003;35:985-991.
4.
Tsujikawa T, Saitoh Y, Andoh A, et al: Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: preliminary experiences. Endoscopy 2008;40:11-15.
5.
Akerman P, Agrawal D, Cantero D, et al: Spiral enteroscopy with the new DSB overtube: a novel technique for deep peroral small bowel intubation. Endoscopy 2008;40:974-978.
6.
Aktas H, Mensik PB: Small bowel diagnostics: current place of small bowel endoscopy. Best Pract Res Clin Gastroenterol 2012;26:209-220.
7.
Hansman J, Eichholz J: Radiologische Diagnostik des Dünndarms. Radiologe 2012;52:849-866.
8.
Hartmann D, Schmidt H, Bolz G, et al: A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc 2005;61:826-832.
9.
May A, Albers J, Hartmann D, et al: Update des Positionspapiers der Sektion Endoskopie der DGVS, Stand 07/2010. Z Gastroenterol 2010;48:1384-1404.
10.
Taylor AC, Chen RY, Desmond PV: Use of an overtube for enteroscopy - does it increase depth of insertion? A prospective study of enteroscopy with and without an overtube. Endoscopy 2001;33:227-230.
11.
Iida M, Yamamoto T, Yao T, et al: Jejunal endoscopy using a long duodenofiberscope. Gastrointest Endosc 1986;32:233-236.
12.
Keizman D, Brill S, Umansky M, et al: Diagnostic yield of routine push enteroscopy with a graded-stiffness enteroscope without overtube. Gastrointest Endosc 2003;57:877-881.
13.
Lin S, Branch MS, Shetzline M: The importance of indication in the diagnostic value of push enteroscopy. Endoscopy 2003;35:315-321.
14.
Belaiche J, Van Kemseke C, Louis E: Use of enteroscope for colo-ileoscopy: low yield in unexplained lower gastrointestinal bleeding. Endoscopy 1999;31:298-301.
15.
Landi B, Cellier C, Fayemendy L, et al: Duodenal perforation occurring during push enteroscopy. Gastrointest Endosc 1996;43:631.
16.
Barkin J, Lewis B, Reiner D, et al: Diagnostic and therapeutic jejunostomy with a new, longer enteroscope. Gastrointest Endosc 1992;38:55-58.
17.
Yang R, Laine L: Mucosal stripping: a complication of push enteroscopy. Gastrointest Endosc 1995;41:156-158.
18.
Adler SN, Bjarnason I, Metzger YC: New balloon-guided technique for deep small-intestine endoscopy using standard endoscopes. Endoscopy 2008;40:502-504.
19.
Möschler O, May AD, Müller MK, Ell C; DBE-Studiengruppe Deutschland: Complications in double-balloon enteroscopy: results of the German DBE registry (in German). Z Gastroenterol 2008;46:266-270.
20.
Gerson LB, Batenic MA, Newsom SL, et al: Long-term outcomes after double-balloon enteroscopy for obscure gastrointestinal bleeding. Clin Gastroenterol Hepatol 2009;7:664-669.
21.
Mensink P, Haringsma J, Kucharzik T, et al: Complications of double balloon enteroscopy: a multicenter survey. Endoscopy 2007;39:613-615.
22.
May A, Nachbar L, Pohl J, et al: Endoscopic interventions in the small bowel using double-balloon enteroscopy: feasibility and limitations. Am J Gastroenterol 2007;102:527-535.
23.
Kav T, Balaban Y, Bayraktar Y: The power suction maneuver in single balloon enteroscopy. Endoscopy 2008;40:961-962.
24.
May A, Nachbar L, Ell C: Push-and-pull enteroscopy using a single-balloon technique for difficult colonoscopy. Endoscopy 2006;38:395-398.
25.
Mönkemüller K, Fry LC, Bellutti M, et al: ERCP using single-balloon instead of double-balloon enteroscopy in patients with Roux-en-Y anastomosis. Endoscopy 2008;40:E19-E20.
26.
Kawamura T, Yasuda K Tanaka K, et al: Clinical evaluation of a newly developed single-balloon enteroscope. Gastrointest Endosc 2008;68:1112-1116.
27.
Tominaga K, Iida T, Nakamura Y, et al: Small-intestine perforation of endoscopically unrecignized lesions during peroral single-balloon enteroscopy. Endoscopy 2008;40(suppl 2): E213-E214.
28.
Ramchandani M, Reddy DN, Gupta R, et al: Diagnostic yield and therapeutic impact of single-balloon enteroscopy: series of 106 cases. J Gastroenterol Hepatol 2009;24:1631-1638.
29.
May A, Färber M, Aschmoneit I, et al: Prospective multicenter trial comparing push-and-pull enteroscopy with the single- and double-balloon techniques in patients with small-bowel disorders. Am J Gastroenterol 2010;105:575-581.
30.
Aktas H, de Ridder L, Haringsma J, et al: Complications of single-balloon enteroscopy: a prospective evaluation of 166 procedures. Endoscopy 2010;42:365-368.
31.
Akerman P: Severe complications of spiral enteroscopy in the first 1750 patients. Gastrointestinal Endosc 2009;69:AB127.
32.
Witkin AS, Fenkel JM, Infantolino A, et al: Spiral enteroscopy in geriatric patients: retrospective review of a single-center experience. Gastrointest Endosc 2010;71:AB371.
33.
Judah JR, Draganov PV, Lam Y, et al: Spiral enteroscopy is safe and effective for an elderly United States population of patients with numerous comorbidities. Clin Gastroenetrol Hepatol 2010;8:572-576.
34.
Messer I, May A, Manner H, et al: Prospective, randomized single-center trial comparing double-balloon enteroscopy and spiral enteroscopy in patients with suspected small-bowel disorders. Gastrointestinal Endosc 2013;77:241-249.
35.
May A, Färber M, Aschmoneit I, et al: Prospective multicenter trial comparing push-and-pull enteroscopy with single- and double-balloon techniques in patients with small-bowel disorders. Am J Gastroenterol 2010;105:575-581.
36.
Takano N, Yamada A, Watabe H, et al: Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial. Gastrointest Endosc 2011;73:734-739.
37.
Domagk D, Mensink P, Aktas H, et al: Single- vs. double-balloon enteroscopy in small-bowel diagnostics: a randomized multicenter trial. Endoscopy 2011;43:472-476.
38.
May A: Small bowel endoscopy. Endoscopy 2012;44:375-377.
39.
May A, Manner H, Aschmoneit I, et al: Prospective, cross-over, single-center trial comparing oral double-balloon enteroscopy and oral spiral enteroscopy in patients with suspected small-bowel vascular malformations. Endoscopy 2011;43:477-483.
40.
Despott EJ, Hughes S, Marden P, et al: First cases of spiral enterosopy in the UK: let's ‘torque' about it! Endoscopy 2010;42:517.
41.
Lara LF, Singh S, Sreenarasimhaiah J: Initial experience with retrograde overtube-assisted enteroscopy using a spiral tip overtube. Proc (Bayl Univ Med Cent) 2010;23:130-133.
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2013
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