Endoscopy 2007; 39(9): 788-792
DOI: 10.1055/s-2007-966753
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Double-balloon colonoscopy after failed conventional colonoscopy: a pilot series with a new instrument

G.  Gay1 , M.  Delvaux1
  • 1Department of Internal Medicine and Digestive Diseases, Hôpitaux de Brabois, CHU de Nancy, Vandoeuvre les Nancy, France
Further Information

Publication History

submitted 2 February 2007

accepted after revision 22 June 2007

Publication Date:
17 August 2007 (online)

Background and study aims: The endoscopes that were developed for double-balloon enteroscopy have been successfully used in cases of failed colonoscopy. This study was a pilot series in which a new colonoscope was tested that utilized this double-balloon principle.

Patients and methods: A total of 29 patients (5 men, 24 women; mean age 54 years) in whom conventional colonoscopy had failed were included in this study. Both the failed colonoscopy and the double-balloon colonoscopy procedures were performed under general anesthesia, the usual practice in France. A prototype instrument (working length 152 cm, diameter 9.4 mm) designed to incorporate the principles of double-balloon enteroscopy was used. The completeness of colonoscopy was assessed according to conventional criteria by the achievement of a stable position in the cecum. The indicatons for the procedure, the time to reach the cecum, the need for fluoroscopic control, and adverse events were recorded.

Results: The previous colonoscopy failed due adhesions (n = 16), or to long or fixed loops (n = 13). Complete colonoscopy using the balloon method was achieved in 28/29 patients, taking an average time of 18 ± 14 minutes; a long sigmoid loop limited the examination to the left flexure in one patient. Balloon colonoscopy using double-balloon methodology was used in 24 patients and the instrument was used without an overtube (i. e. using a single-balloon technique) in five patients. Fluoroscopy was used in 16 patients to monitor endoscope progression. No complications were reported.

Conclusions: Double-balloon colonoscopy enables full colonic examination in almost all patients with a previous incomplete colonoscopy. The overtube should be used in most cases. The use of fluoroscopic assessment of scope progression could be reduced further with increasing experience.

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M. Delvaux, MD

Department of Internal Medicine and Digestive Diseases

Hôpitaux de Brabois Adultes

CHU de Nancy

F-54511 Vandoeuvre les Nancy

France

Fax: +33-383154012

Email: 106521.3337@compuserve.com