Modern enteroscopy techniques: an overview of technologies and equipment for diagnostics and treatment of digestive tract diseases

The main types of enteroscopy

For a long time, fluoroscopy was the only method available for studying the small intestine. In this technique, a contrast agent was injected, and the doctor assessed the mucosal relief and peristalsis speed from X-ray images. However, this method did not provide a precise view of the disease and had several contraindications.

Currently, enteroscopy is recognized as the most effective method for examining the mucosa of the small intestine. It provides the most reliable data for diagnosing diseases, helping to identify areas of inflammation and detect tumors or pre-tumor conditions. Additionally, during the examination, the doctor can perform a biopsy for histological analysis. Endoscopic equipment allows you to perform medical manipulations such as:

• removal of polyps;

• extraction of foreign bodies;

• stopping bleeding;

• collection of biomaterial;

• introduction of a probe for enteral nutrition.

Physiological features, localization and extent of the small intestine make its examination difficult. An enteroscope has a thin tube with a diameter of up to 1 cm, which is inserted into the intestine. The instrument helps to conduct an examination and perform therapeutic procedures without opening.

In modern medicine, several methods of enteroscopy are used: jejunoscopy, ileoscopy, capsule endoscopy, and balloon endoscopy. Jejunoscopy examines the upper parts of the small intestine and is performed orally. This procedure is known as fibrogastroscopy, and it uses advanced equipment such as fibrogastroduodenoscopes

Ileoscopy involves examining the final parts of the small intestine through the anal ring. This technique is known as fibrocolonoscopy. For this examination, devices called colonoscopes are used. These have a wide channel that allows for the additional introduction of a thin endoscope.

Capsule enteroscopy is a research method in which the patient swallows a capsule containing a video camera. When entering the intestine, the capsule endoscope with a camera captures and broadcasts data to a computer monitor.

Double-balloon enteroscopy is a technique developed in 2001 that involves using an enteroscope with a flexible tube. During the procedure, cylinders are alternately inflated and deflated as the scope travels through the intestine. Double-balloon enteroscopy is praised for its high maneuverability and allows for retroflexion, which is not possible with colonoscopy. This technique enables the specialist to detect bleeding and perform hemostasis.

Technology and equipment for enteroscopy

In enteroscopy practice, video endoscopy racks are often used. These multi-sectional systems are essential for diagnosing diseases, performing surgical procedures, and conducting biopsies. The mobile system enhances the comfort of medical professionals and improves the speed and accuracy of procedures. The hardware component of the rack includes the following basic equipment:

• video endoscope;

• light source;

• monitor;

• instrument stand;

• electrosurgical equipment.

The set can be supplemented with an insufflator and other instruments. The medical institution can upgrade the rack at any time to expand its functionality and add new equipment.

The design is highly mobile, allowing easy movement and secure positioning. All equipment and accessories are organized on a single rack, and its compact design helps save space in a medical facility. Each element of the system has a designated place and is directly accessible, with special clamps and holders for instruments. Most video endoscopy racks are equipped with power filters, cable channels, and a grounding system, which ensures safety and reduces the risk of damage to power cords during transportation.

Indications for Enteroscopy

Enteroscopy has specific indications. It is recommended by a specialist if there are suspicions of polyps, tumors, foreign bodies, or bleeding in the small intestine. It is also indicated for prolonged diarrhea of unknown origin, abdominal pain, progressive weight loss, and fainting.

Enteroscopy has both indications and contraindications:

• severe condition of the patient;

• diseases that impede the passage of the device;

• goiter, strictures in the digestive tract;

• myocardial infarction;

• cardiopulmonary insufficiency;

• severe tumors of the small intestine;

• recent surgeries;

• impaired cerebral circulation.

For patients with mental disorders, blood diseases, severe hypertension, or inflammation of the upper respiratory tract or oral cavity, enteroscopy should be performed only with the approval of specialists. Due to the invasiveness and technical complexity of the procedure, it is recommended to clarify the diagnosis with preliminary capsule endoscopy if pathological changes are detected.

The process of conducting enteroscopy

What is enteroscopy? This study is conducted upon the referral of a therapist or gastroenterologist. To access the upper parts of the small intestine, the endoscope is introduced through the mouth. To examine the lower part, the device is inserted through the anus. The duration and specifics of the procedure depend on the type of enteroscopy. Capsule endoscopy, colonoscopy, and gastroscopy are usually performed on an outpatient basis, while balloon enteroscopy requires the patient to stay in the hospital. Procedures are performed after administering anesthetic medications, as the injection of air can cause discomfort. After the study is completed, the patient must remain under the supervision of the doctor.

Enteroscopy may sometimes cause minor complications. The most common issues include a sore throat and damage to the walls of the intestine or stomach. Bleeding can occur when removing polyps or performing biopsies. Additionally, the sedatives administered may cause allergic reactions.

Trends and prospects for development

Modern enteroscopy is highly effective because it is performed in two stages. First, a video capsule is used to visualize the small intestine and identify the level of the pathological process. Subsequently, balloon enteroscopy allows for microsurgical manipulations at the site of the lesion, including the removal of neoplasms, collection of biopsy material, and cessation of bleeding.

Endoscopy receives positive feedback due to its advancements, which have made it possible to perform diagnosis and treatment without extensive surgical procedures. Research techniques are continually evolving, incorporating modern medical technologies. The development of endoscopic techniques focuses on reducing the size of recording devices, enhancing image clarity, and expanding the capabilities for manipulation at the site of the lesion.

Conclusion

Enteroscopy is an accurate endoscopic examination method that allows for the inspection of the mucosa of the small intestine to detect or rule out the development of pathologies. Thanks to modern technology, this technique can identify diseases at an early stage, which increases the chances of full recovery.

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