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Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 113466
Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.113466
Motorized spiral enteroscopy in altered anatomy: Balancing clinical success with safety challenges
Ammara Abdul Majeed, Amna S Butt
Ammara Abdul Majeed, Amna S Butt, Department of Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan
Author contributions: Majeed AA and Butt AS both had reviewed the article, performed literature search and written the letter to the editor.
Conflict-of-interest statement: All authors have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amna S Butt, Associate Professor, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan. amna.subhan@aku.edu
Received: August 26, 2025
Revised: September 14, 2025
Accepted: October 15, 2025
Published online: November 16, 2025
Processing time: 80 Days and 10.7 Hours
Core Tip

Core Tip: Endoscopic retrograde cholangiopancreatography in Roux-en-Y anatomy remains technically challenging, with higher success through bilioenteric anastomosis than the native papilla. Emerging strategies including balloon-assisted enteroscopy, motorized spiral enteroscopy (MSE) and endoscopic ultrasound-guided drainage highlight the need for personalized procedural selection based on anatomy, clinical scenario, and institutional expertise. MSE offers high diagnostic and therapeutic potential but requires further refinement to address safety concerns before wider adoption.