The California Pacific Medical Center Interventional Endoscopy Service (IES) is now offering Double Balloon Enteroscopy. Utilizing a specialized endoscope, this new technique allows physicians to perform both diagnostic and therapeutic procedures within the small bowel without open surgery. Kenneth Binmoeller, M.D., the medical director of IES at California Pacific and Ann Chen, M.D., are performing Double Balloon Enteroscopy allowing complete examination of small intestine, notoriously one of the most inaccessible areas of the GI tract. The new double-balloon enteroscope features two balloons, one attached to the distal end of the scope and the other attached to a transparent tube sliding over the endoscope. When inflated with air, the balloons can grip sections of the small intestine and "shorten" the small intestine by pleating it over the endoscope. Sequential shortening of the small intestine over the endoscope and advancement of the endoscope enables a comprehensive examination of the entire small intestine.

Dr. Binmoeller, quoted in Medical Devices & Surgical Technology Week an on-line publication via NewsRx.com, states "Upper endoscopy and colonoscopy allow us to see only the two extreme ends of the gastrointestinal tract. The small intestine, which is around 25 feet long, has been the 'blind spot' beyond our reach. Even the imaging capsule swallowed by a patient provides only random 'snapshots' while traveling through the gut. Double Balloon enteroscopy now changes that. We not only are able to drive an endoscope through the entire small intestine, but can perform treatments to stop bleeding, remove polyps and destroy tumors."




Endoscopic view of an arteriovenous malformation (AVM) in the mid small intestinal


The Double Balloon enteroscopy system was developed and is manufactured by a Japanese company, Fujinon, Inc. The system received Federal Drug Administration (FDA) in June 2004 and allows examination and treatment of the entire small intestine, produces high-quality images, shortens procedure time, and reduces patient discomfort.
Image courtesy of www.fujinonendoscopy.com.
Double Balloon Enteroscopy enables targeted intervention making biopsies, injections, and removal and ablation techniques in the small intestine possible without surgery. If a lesion is found in the small intestine that requires surgery, tattooing of the region and biopsies for tissue diagnosis by double balloon enteroscopy can also provide important information to help surgeons plan for the
appropriate type of surgery, which may translate into smaller incisions and less invasive operations as well as shorter recovery times.
Endoscopic view after treatment with argon plasma coagulation

Learn more about the California Pacific's Interventional Endoscopy Service.