The most modern and recent endoscopy method used in the diagnosis and treatment of small bowel disorders, Spiral Enteroscopy, has revolutionized small bowel endoscopy, proving that its use is not only beneficial for patients, but is an important tool for doctors as well. This technique received approval in Europe in March 2019 and, so far, it is used in a few centres in Europe. In Greece, the "Agios Loukas" Clinic is the first clinic in Thessaloniki that has installed the Olympus Power Spiral endoscopic system, which is used exclusively by specially trained doctors of the Clinic.
What is in force to date
The small intestine is a region of the gastrointestinal tract that is difficult to access, as it is long (about 6 metres), multifaceted and beyond the reach of conventional endoscopic instruments. At the "Agios Lukas" Clinic we decided to proceed with the purchase and use of this revolutionary new technology, being the only hospital in Northern Greece that uses this method. Spiral enteroscopy, unlike other imaging examinations, is not just a diagnostic tool, but allows the specialized gastroenterologist to perform invasive operations inside the small intestine, enabling him to immediately diagnose and treat pathologies of the small intestine.
What is the advantage of spiral enteroscopy and when do we use this technique?
Current endoscopic methods used to date rarely achieve complete control of the small bowel and usually require a long time to pass the small bowel.
With spiral enteroscopy we can quickly check the inside of the small intestine and perform therapeutic interventions without time-consuming invasive surgical techniques, with the advantage of ease of use and the ability to pass through the intestinal tract in a very short time. The therapeutic indications are control and treatment of bleeding from the small intestine, investigation and treatment of strictures - inflammation, removal of polyps and removal of foreign bodies from the small intestine.
More recent data
Finding out what is inside a patient's small intestine, which is on average 6 metres long, has always been a challenge for the interventional gastroenterologist. The area is inaccessible and treatment was, until recently, traditionally surgical. Conventional methods of investigating small bowel disease, such as capsule endoscopy, are only diagnostic, with no therapeutic potential. Other endoscopic techniques are laborious, time-consuming and increase the requirement for anaesthesia, as it takes up to two hours to completely pass the small intestine. In contrast, spiral enteroscopy does this task in just 40-50 minutes. The technology allows for rapid evaluation of the small bowel and can also obtain biopsies of lesions, tumours, polyps and strictures.
How does it work?
The motorised spiral enteroscope has an integrated motor operated by a foot pedal, which drives the rotation of the spiral section. The examination is performed under sedation or general anaesthesia and the endoscope is advanced by means of the mechanically rotating coil into the small intestine. Under the guidance of the endoscope, a thorough inspection of the lumen of the small intestine is carried out. If any lesion is found, an intervention can be performed through the working channel of the enteroscope, i.e. biopsy, polypectomy, haemostasis with cautery or endoscopic clip insertion, ink marking and other endoscopic interventions.
Experience
Patients benefit significantly from this test. The first patient in whom we performed spiral enteroscopy benefited immensely, as we were able to easily find the area of the narrowed small bowel and dilate it in the same setting. All this was done within an hour, which would not have been possible with conventional methods. Although it was only recently introduced to the Clinic in February 2021, the technique has been found to be extremely useful in the management of patients with small bowel disease. Of all the patients in whom the technique was used, the cause was definitively treated in all cases. It should also be noted that the complication rate is particularly low, due to:
a) thorough preoperative examination
b) the extensive experience of interventional endoscopists
c) close post-operative monitoring
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