Motorized spiral enteroscopy in altered anatomy: Balancing clinical success with safety challenges

Table 1 Differences between double-balloon enteroscopy and single-balloon enteroscopy, motorized spiral enteroscopy, and endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography

Ref.	Feature	Technique	Procedure time	Technical success (enteroscopy)	Complications rate
Koh et al[6]	DBE	Two balloons (scope + over tube) alternate inflation for bowel anchoring and advancement	Longer total procedure time, especially in deep insertion cases	High (approximately 93%-95%)	Low (approximately 1%-4%), primarily minor mucosal tears or bleeding
Koh et al[6]	Single-balloon enteroscopy	One balloon on over tube inflates for fixation: Scope tip manual anchoring	Slightly shorter than DBE	High (approximately 90%-98%)	Low, similar to DBE
Mussetto et al[5]	Motorized spiral enteroscopy	Motorized rotating spiral over tube pleats small bowel for advancement	Generally shortest procedure time due to motorized advancement	Comparable (approximately 88%-95%)	Higher; reported esophageal mucosal injuries, withdrawals, and rare serious adverse events led to market withdrawal
Kedia et al[7]	EUS-directed transgastric endoscopic retrograde cholangiopancreatography	EUS-guided puncture and drainage or stent placement for biliary access	Variable; can be shorter but depends on approach complexity	Indirect (not an enteroscopy technique; access success varies)	Moderate; risks include bile leak, perforation, pancreatitis

DBE: Double-balloon enteroscopy; EUS: Endoscopic ultrasound.