Diagnostic yield and therapeutic impact of novel motorized spiral enteroscopy in small-bowel disorders: a single-center real-world experience from a tertiary care hospital (with video)

Abstract Background and Aims Novel motorized spiral enteroscope (NMSE) is a recent advancement in the field of enteroscopy and offers multiple features including self-propulsion, better irrigation, and shorter enteroscope length with a larger channel. The aim of this study was to evaluate the efficacy in terms of diagnostic yield and therapeutic success of NMSE in patients undergoing enteroscopy by antegrade and/or retrograde approaches for suspected small-bowel disease (SBD). Methods We retrospectively evaluated consecutive patients with symptomatic SBD who underwent enteroscopy over a 6-months period. Diagnostic yield, therapeutic success, total enteroscopy rate (TER), technical success (TS), total procedural time, depth of maximal insertion (DMI), and adverse events related to the NMSE procedure were noted. Results Out of 61 patients (mean age of 45.67±15.37, 43 males) included for NMSE, 57 patients underwent successful enteroscopy with TS of 93.4%. The overall diagnostic yield was 65.5% (95% CI, 52.31 – 77.27) and 70.1% (95% CI, 56.60 – 81.57) in patient who underwent successful NMSE; TER was 60.6%: 31.1% by antegrade approach and 29.5% by combined antegrade and retrograde approach. DMI and procedural time was of 465 cm (100-650) and 40 minutes (25-60) by antegrade and 140 cm (50-200) and 35 minutes (30-60) by retrograde route. Lesions were classified as inflammatory (n=25), vascular (n=10) and mass (n=4). Biopsy specimens were obtained in 50.8% subjects and 23% patients underwent therapeutic procedures. No major adverse events were seen. Conclusions NMSE is a promising technology, showing high efficacy as a diagnostic and therapeutic tool in the management of otherwise difficult-to-treat SBD.