Introduction: The small intestine has always been an area that has been difficult to access by endoscopist. Currently available modalities for small bowel enteroscopy is often time consuming and rarely accomplish complete small bowel evaluation. Novel Motorized Spiral Enteroscopy is the latest minimally invasive technology that has created a paradigm shift in the small bowel diagnostic and therapeutic, with speed and ease adding to the attractiveness of the procedure. Limited data is available on the efficacy and safety of NMSE in patients with small bowel disorders. Here we report our initial experience with this novel device.
Methods: This is a retrospective study of 12 consecutive patients with suspected small bowel disease over last 5 months. Patients were assessed in terms of diagnostic and therapeutic yield, technical success, total enteroscopy rate (TER), depth of maximal insertion (DMI), median insertion time and adverse events.
Results: During the period of 5 months, 12 patients (9 male, 3 females) with a mean age of 42 ± 15.11 years underwent NMSE for three specific indications, unexplained abdominal pain, Chronic diarrhea of unexplained etiology and obscure GI bleed. Technical success was achieved in 91.6% using antegrade route and 50% by retrograde route. Pan-enteroscopy rate (TER) was 58.33%, antegrade enteroscopy to the cecum was achieved in 25% and in 33.33% NMSE was combined with another retrograde modality to achieve pan-enteroscopy. No enteroscopy associated major adverse effect seen. Median depth of maximal insertion was 430 cm (Range 100-550) and median insertion time to DMI was 85 min (Range 40- 120) in antegrade route and 60 min (Range 40- 70). Most common findings were ulcero-stricturing lesion in 25%, Vascular lesion with suggestion of recent bleed in 2 (16.6%) patients which were managed by APC, mass lesion in 1patient which was diagnosed as lymphoma on biopsy. One or the other form of endotherapy therapy was done in 25% of the cases with overall diagnostic and therapeutic yield of 75% each.
Discussion: NMSE is an promising alternative technique for diagnostic and therapeutic enteroscopy which scores favourably over the existing deep enteroscopy devices in terms of procedural ease, duration, safety and yields. Further comparative randomized controlled trials are required for head-to-head comparisons between NMSE and BAE and to analyze its impact on the diagnostic and therapeutic yield, transfusion burden and overall survival.
Pankaj Singh indicated no relevant financial relationships.
Sawan Bopana indicated no relevant financial relationships.
Surakshith TK indicated no relevant financial relationships.
Muzaffer Rashid Shawl indicated no relevant financial relationships.
Pallavi Garg indicated no relevant financial relationships.
Kausal Madan indicated no relevant financial relationships.
Vikas Singla indicated no relevant financial relationships.
Pankaj Singh, MD, DM1, Sawan Bopana, MD, DM2, Surakshith TK, MD, DNB2, Muzaffer Rashid Shawl, MD, DNB2, Pallavi Garg, MD, DNB2, Kausal Madan, MD, DM2, Vikas Singla, MD, DM2. P1963 - Novel Motorized Spiral Enteroscopy (NMSE), A Revolutionary New Technology in the Management of Small Bowel Disorders. A Single Center Experience From India, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.