Balloon Endoscopy

1 What is a Balloon Endoscopy?

Balloon endoscopy can be performed with a single balloon and double balloon.

Upper and lower gastrointestinal endoscopes helps diagnose and treat diseases of the esophagus, stomach, duodenum, and colon (large intestine).

Wireless capsule endoscopy allows physicians to visualize the inside of the intestines from the esophagus through to the colon, but capsule endoscopy has limitations – the most notable are the inability to control the capsule's passage and to perform therapy, for example, biopsy and electrocautery.

In single balloon endoscopy, a 200 cm long flexible, fiberoptic endoscope (a hose-like tube one centimeter in diameter with a light and a camera on the tip) is fitted with an equally long overtube that slides the full length of the endoscope.

The balloon can be blown up and deflated on the tip of the overtube and when it is blown up it is used to anchor the overtube within the intestine.

The endoscope can be advanced further into the small intestine while the overtube is anchored. The small intestine can be shortened and straightened to make the passage of the inner endoscope easier by withdrawing the overtube. The balloon may then be deflated so that the overtube can be inserted further and the endoscope advanced again.

In itself, the endoscope is a standard endoscope with working channels that allow the intestine to be inflated with air, rinsed with water, or to guide biopsy or electrocautery instruments to the tip of the endoscope.

Double balloon endoscopy is similar, but a second balloon is located on the tip of the endoscope. Both balloons can be alternatively inflated to anchor the overtube or the endoscope to assist with the passage of the endoscope or overtube, respectively.

Balloon endoscopy, like another gastrointestinal endoscopy, requires intravenous sedation. The procedures are long, often requiring 1-3 hours. The most important complications of balloon endoscopy are perforation of the small intestine or bleeding either due to insertion of the endoscope or use of therapeutic instruments.