Utility of Motorized Spiral Enteroscopy
Vanessa M. Shami, MD, FASGE, reviewing Beyna T, et al. Endoscopy 2022 Apr 21.
Motorized spiral enteroscopy (MSE) is innovative technology designed to facilitate advancement of the enteroscope across the small bowel. Preliminary studies have shown MSE to be safe and effective for deep enteroscopy performed at expert centers in patients with normal anatomy. The aim of this international, multicenter, prospective, observational study was to evaluate the safety, efficacy, and learning curve associated with MSE in patients with normal anatomy as well as those with altered anatomy.
The study enrolled 298 patients (120 females) from 10 European centers. Of these patients, 54 (21.5%) had previous abdominal surgery and 25 (10.0%) had surgically altered anatomy. The overall rate of severe adverse events (SAE) was 2.3%, occurring in 7 of 298 patients (95% confidence interval, 0.9%-4.8%).
For endoscopists who performed fewer than 20 MSE cases before the study, the first 5 cases performed for the study were considered learning-curve cases and designated to the training group. Cases performed by this group of endoscopists after the fifth case were allocated to the core group. All cases performed by experienced MSE endoscopists (who completed >20 MSEs prior to the study) were assigned to the core group. The SAE rates were 2.0% (5/251) in the core group and 4.3% (2/47) in the training group and were unaffected by abdominal surgery (1.9%). The area of clinical interest was reached in 295 of 337 procedures (87.5%).
COMMENTMSE appears to be feasible and safe in a large cohort of patients after a short learning curve. Additionally, MSE was feasible in postsurgical patients and patients with altered anatomy without increasing the rate of adverse events. Additional large prospective studies are needed to confirm these findings.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Beyna T, Moreels T, Arvanitakis M, et al. Motorized spiral enteroscopy: results of an international, multicenter, prospective observational clinical study on patients with normal and altered gastrointestinal anatomy. Endoscopy 2022 Apr 21. (Epub ahead of print) (https://doi.org/10.1055/a-1831-6215)
