Although a conventional endoscope with a long working length generates concern about maneuverability, the tip of the double-balloon endoscope can be manipulated with the help of a fixed point supported by the balloon at the tip of the overtube. This enables free back-and-forth observation without sacrifice of maneuverability no matter how deeply the endoscope is inserted. Moreover, this method allows insertion from both the mouth and the anus because insertion does not depend on peristalsis of the intestine. Observation of a surgically bypassed segment of the intestine is not possible by the ropeway method, sonde method, or even capsule endoscopy; but it is possible with the double-balloon endoscope.
The tip of the double-balloon endoscope has bending capability (up and down, left and right) and a forceps channel; and it allows directed biopsy, which cannot be performed by the ropeway method or the sonde method. Endoscopic treatment can be performed with a therapeutic device. A therapeutic device with a large diameter may be used without being restricted by the forceps channel diameter after removal of the endoscope with the overtube left in place. The use of a double-balloon endoscope allows endoscopic treatment of lesions in any portion of the small intestine.
It should be noted that this procedure dramatically reduces the patient's discomfort related to endoscopy compared with the push method. Most endoscopy-related discomfort is due to stretching the curved or looped portion of the intestine. Double-balloon endoscopy causes less discomfort due to stretching of the intestine because the method, in principle, allows insertion while inhibiting stretching of the intestine.
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