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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5540_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Preface
- •Acknowledgments
- •Contents
- •Editors and Contributors
- •Editors
- •Contributors
- •1.1.1 Introduction
- •1.2.3 Single-Balloon Enteroscopy
- •1.2.4 Spiral Enteroscopy
- •1.2.5 Push Enteroscopy
- •1.2.6 Intraoperative Enteroscopy
- •1.3.1 Introduction
- •1.3.2.1 Small-Bowel Bleeding Lesions
- •1.3.2.3 Crohn’s Disease
- •1.3.2.5 Foreign Body Removal
- •1.3.2.7 Other Indications
- •1.3.4 Contraindications
- •1.2.1 Introduction
- •1.2.2 Double-Balloon Enteroscopy
- •1.3.5 Conclusion
- •1.4.4 Conclusion
- •References
- •2: Double-Balloon Enteroscopy
- •2.1 Introduction
- •2.2.1 Enteroscope
- •2.2.2 Fluoroscopy
- •2.2.3 Accessory Devices
- •2.2.4 Personnel
- •2.2.5 CO2 Insufflator
- •2.3 General Preparations
- •2.3.1 Consent Form
- •2.3.3 Transoral Examination
- •2.3.4 Transanal Examination
- •2.3.5 Sedation
- •2.4 Procedure Preparation
- •2.4.1 Instruments
- •2.4.2 Insufflation
- •2.5 Insertion Technique
- •2.5.2 Transoral Insertion [7, 8]
- •2.5.3 Transanal Insertion [7, 8]
- •References
- •3: Single-Balloon Enteroscopy
- •3.1 Introduction
- •3.2.1 Enteroscope (SIF-Q180)
- •3.2.2 Overtube (Splint Tube, ST-SB1)
- •3.2.3 Air Infusion Pump (Olympus Balloon Control Unit, OBCU)
- •3.3.1 Antegrade Enteroscopy
- •3.3.2 Retrograde Enteroscopy
- •3.3.3 Sedation Method
- •3.4 Patient Monitoring
- •3.6 Insertion Method
- •3.6.4 Deep Insertion Method
- •3.7.2 Compression Method
- •References
- •4.4 Hemostatic Procedures
- •4.4.5.1 Vascular Lesions
- •4.4.5.2 Inflammatory Lesions
- •4.4.5.3 Tumorous Lesions
- •4.5 Polyp Treatment
- •4.5.2 Mild Intussusception Mimicking Pedunculated Polyps
- •4.6.3 Post-Treatment Follow-Up
- •4.7.2 Perform Retrograde BAE First
- •4.7.9 Post-treatment Follow-Up
- •4.8 Stricture Dilation
- •4.8.5 Preparation
- •4.8.8 Minimal Water Exchange Method
- •4.8.9 Target Dilation Diameter
- •4.8.12 Gradual Balloon Dilation
- •4.8.13 Scope Passage After EBD
- •4.8.17 Follow-Up After EBD
- •4.9 Summary
- •References
- •5.1 Altered Anatomical Structures
- •5.1.1 Introduction
- •5.1.4 Conclusion
- •5.2 Difficult Colonoscopy Insertion
- •5.2.1 Introduction
- •5.2.3.1 Device-Assisted Small Bowel Enteroscopy
- •References
- •6: Other Small Bowel Endoscopies
- •6.1 Push Enteroscopy
- •6.1.1 Introduction
- •6.1.2 Indication
- •6.3.4 Manual Spiral Enteroscopy
- •6.3.5 Motorized Spiral Enteroscopy
- •6.3.6 Clinical Outcomes
- •6.3.6.1 Manual Spiral Enteroscopy
- •6.2 Intraoperative Enteroscopy
- •6.2.1 Introduction
- •6.2.2 Indication
- •6.2.2.1 Indications [11]
- •6.2.2.2 Contraindications
- •6.2.3 Technique
- •6.2.3.1 Abdominal Exploration
- •6.2.3.2 Intraoperative Enteroscopy Approaches
- •6.2.3.3 Practical Aspects
- •6.2.4 Clinical Outcomes
- •6.2.4.2 Complications
- •6.2.5 Conclusion
- •6.3 Spiral Enteroscopy
- •6.3.1 Introduction
- •6.3.2.1 Indications
- •6.3.2.2 Contraindications
- •6.3.6.2 Transanal Spiral Enteroscopy
- •6.3.6.4 Motorized Spiral Enteroscopy
- •6.3.7.1 Manual Spiral Enteroscopy
- •6.3.7.2 Motorized Spiral Enteroscopy
- •6.3.8 Conclusion
- •References
- •7.1 Neoplastic Lesions
- •7.1.1 Small-Bowel Cancer [1]
- •7.1.2 Lymphoma
- •7.1.3 Gastrointestinal Stromal Tumor (GIST)
- •7.1.4 Neuroendocrine Tumor (NET)
- •7.1.5 Metastatic Cancer
- •7.1.7 Hemangioma
- •7.1.8 Ectopic Pancreas
- •7.1.9 Lipoma
- •7.2 Inflammatory Lesions
- •7.2.1 Small-Bowel Crohn’s Disease [4, 5]
- •7.2.2 Small-Bowel Tuberculosis
- •7.2.3 Intestinal Behçet’s Disease
- •7.2.5 Ischemic Enteritis
- •7.2.6 Graft-Versus-Host Disease (GVHD)
- •7.2.7 Cytomegalovirus (CMV) Enteritis
- •7.2.8 Eosinophilic Enteritis
- •7.2.9 Radiation Enteritis
- •7.2.10 Henoch-Schönlein Purpura
- •7.3 Small-Bowel Vascular Lesions
- •7.3.2 Lymphangiectasia
- •7.4 Diverticular Lesions
- •7.4.1 Meckel’s Diverticulum [7]
- •7.4.2 Small-Bowel Diverticulum
- •7.5 Miscellaneous Small-Bowel Disease
- •7.5.1 Amyloidosis
- •7.5.3 Intestinal Adhesion
- •References

Balloon-Assisted
Enteroscopy
Jong-Jae Park
Hironori Yamamoto
Hyun Joo Jang
Sung Noh Hong
Editors
123

Balloon-Assisted Enteroscopy

Jong-Jae Park • Hironori Yamamoto
Hyun Joo Jang • Sung Noh Hong
Editors
Balloon-Assisted
Enteroscopy

Editors
Jong-Jae Park
Division of Gastroenterology, Department
of Internal Medicine
Korea University College of Medicine
Seoul, Korea (Republic of)
Hironori Yamamoto
Department of Medicine, Division of
Gastroenterology
Jichi Medical University
Shimotsuke, Tochigi, Japan
Hyun Joo Jang
Department of Gastroenterology
Hallym University School of Medicine
Hwaseong, Kyonggi-do, Korea
(Republic of)
Sung Noh Hong
Department of Medicine
Samsung Medical Center, Sungkyunkwan
University School of Medicine
Seoul, Korea (Republic of)
ISBN 978-981-95-2444-0 ISBN 978-981-95-2445-7 (eBook)
https://doi.org/10.1007/978-981-95-2445-7
English translation of the 1st original Korean edition published by SnC Publishing, Seoul, 2021
Translation from the Korean language edition: “Balloon-Assisted Enteroscopy” by Jong-Jae Park etal.,
© SnC Publishing 2021. Published by SnC Publishing. All Rights Reserved.
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore
Pte Ltd. 2025
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specically the rights of reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or
information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
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The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
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This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
If disposing of this product, please recycle the paper.

Preface
Since its introduction in the early 2000s, balloon-assisted enteroscopy (BAE) has
revolutionized the diagnosis and management of small bowel diseases. As one of
the most advanced techniques in gastrointestinal endoscopy, BAE continues to
evolve with innovations in device technology and procedural expertise.
This textbook was conceived to provide a comprehensive, practical, and up-todate reference for clinicians, trainees, and researchers involved in BAE.It covers
the full spectrum of BAE—from fundamental principles and techniques to cuttingedge therapeutic applications—with contributions from leading experts in the eld.
The Korean Society of Gastrointestinal Endoscopy (KSGE), as a long-standing
academic society dedicated to the advancement of gastrointestinal endoscopy, is
proud to support the publication of this book. KSGE has played a pivotal role in
research and education in the eld of gastrointestinal endoscopy, both in Korea and
internationally. This textbook reects our ongoing commitment to promoting excellence in endoscopic practice.
I would like to express my sincere appreciation to the editorial team, contributing
authors, and all those who have supported this endeavor. I hope that this contribution will serve as a valuable guide and inspiration for current and future generations
of endoscopists.
Seoul, South Korea Jong-JaePark
Tochigi, Japan HironoriYamamoto
Hwaseong, South Korea HyunJooJang
Seoul, South Korea SungNohHong
v

Acknowledgments
I would like to convey my deepest gratitude to all the authors who contributed their
invaluable time and expertise to this textbook, amid the intensied clinical burdens
arising from the unprecedented challenges within the Korean healthcare system,
particularly affecting referral hospitals and tertiary care institutions. Their unwavering commitment to excellence in clinical practice and education was essential to
completing each chapter.
Special acknowledgment and sincere appreciation are due to Professor Hironori
Yamamoto of Jichi Medical University in Japan, the inventor of double-balloon
enteroscopy. His pioneering work in 2001 laid the fundamental scientic groundwork upon which this volume is based.
Furthermore, I am profoundly grateful to the Research Group for Capsule
Endoscopy and Enteroscopy of the Korean Society of Gastrointestinal Endoscopy.
The dedicated leadership and diligent efforts of both past and present chairs and
members of the group have signicantly fostered a collaborative and enriching academic environment essential to this project.
Since its establishment as the Gut Image Study Group in August 2004, the
research group has consistently made substantial contributions through multicenter
studies, annual symposia, educational workshops, and the creation of a comprehensive database. Collectively, their efforts have greatly advanced the eld of smallbowel endoscopy. This textbook stands as a tribute to their remarkable achievements
and continued dedication.
Sungkyunkwan University School of Medicine
Seoul, South Korea
Research Group for Capsule Endoscopy and Enteroscopy
Korean Society of Gastrointestinal Endoscopy
Seoul, South Korea
SungNohHongDepartment of Medicine, Samsung Medical Center
vii

Contents
1 Overview of Small Bowel Enteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Seung Min Hong, Hwang Choi, Chang Soo Eun, Beom Jae Lee,
Jae Gon Lee, and Hyun Joo Jang
2 Double-Balloon Enteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Yehyun Park and Seong Ran Jeon
3 Single-Balloon Enteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Jinsu Kim
4 Therapeutic Procedures of Balloon-Assisted Enteroscopy . . . . . . . . . . 45
Tomonori Yano, Satoshi Shinozaki, and Hironori Yamamoto
5 Application of Balloon-Assisted Enteroscopy in Special
Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Dong-Hoon Yang and Eun Ran Kim
6 Other Small Bowel Endoscopies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Bong Min Ko, Hyun Jung Lee, and Jae Jun Park
7 Atlas of Small Bowel Diseases Diagnosed by Balloon-Assisted
Enteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Sung Noh Hong
ix

Editors and Contributors
Editors
Jong-JaePark Division of Gastroenterology, Department of Internal Medicine,
Korea University Guro Hospital, Korea University College of Medicine, Seoul,
South Korea
Hironori Yamamoto Department of Medicine, Division of Gastroenterology,
Jichi Medical University, Tochigi, Japan
Hyun Joo Jang Department of Gastroenterology, Hallym University Dongtan
Sacred Heart Hospital, Hallym University School of Medicine, Hwaseong,
South Korea
Sung Noh Hong Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
Contributors
HwangChoi College of Medicine, The Catholic University of Korea, Incheon,
South Korea
ChangSooEun College of Medicine, Hanyang University, Guri, South Korea
Seung Min Hong Pusan National University College of Medicine, Pusan,
South Korea
Sung Noh Hong Sungkyunkwan University School of Medicine, Seoul,
South Korea
HyunJooJang Hallym University School of Medicine, Dongtan, South Korea
Seong Ran Jeon Soonchunhyang University College of Medicine, Seoul,
South Korea
EunRanKim Sungkyunkwan University School of Medicine, Seoul, South Korea
xi

xii
Editors and Contributors
Jinsu Kim College of Medicine, The Catholic University of Korea, Seoul,
South Korea
Bong Min Ko Soonchunhyang University College of Medicine, Bucheon,
South Korea
BeomJaeLee Korea University College of Medicine, Seoul, South Korea
HyunjungLee Seoul National University College of Medicine, Seoul, South Korea
JaeGonLee
Hallym University School of Medicine, Dongtan, South Korea
JaeJoonPark Yonsei University College of Medicine, Seoul, South Korea
YeHyunPark Ewha Womans University School of Medicine, Seoul, South Korea
SatoshiShinozaki Jichi Medical University, Tochigi, Japan
HironoriYamamoto Jichi Medical University, Tochigi, Japan
Dong-HoonYang University of Ulsan College of Medicine, Seoul, South Korea
TomonoriYano Jichi Medical University, Tochigi, Japan

Overview ofSmall Bowel Enteroscopy
SeungMinHong, HwangChoi, ChangSooEun,
BeomJaeLee, JaeGonLee, andHyunJooJang
1.1 History ofSmall Bowel Enteroscopy
1.1.1 Introduction
The small bowel, approximately 6m in length, poses limitations for endoscopic
examination. While upper gastrointestinal endoscopy can reach the duodenum and
colonoscopy can view the terminal ileum, most of the small bowel remains inaccessible. Traditional methods of small bowel enteroscopy—such as push, sonde, and
ropeway techniques—have been used but allow only partial visualization of the
jejunum. These methods are difcult to perform and often cause considerable discomfort for patients, limiting their broader application. In the twenty-rst century,
capsule endoscopy and balloon-assisted enteroscopy have enabled complete examination of the small bowel, facilitating accurate diagnosis and endoscopic treatment
1
S. M. Hong
Pusan National University School of Medicine, Yangsan, South Korea
e-mail: lucky77i@naver.com
H. Choi (
College of Medicine, The Catholic University of Korea, Seoul, South Korea
e-mail: hwchoi@catholic.ac.kr
C. S. Eun
Hanyang University College of Medicine, Seoul, South Korea
e-mail: cseun@hanyang.ac.kr
B. J. Lee
Division of Gastroenterology, Korea University College of Medicine, Seoul, South Korea
e-mail: L85210@korea.ac.kr
J. G. Lee · H. J. Jang
Hallym University Dongtan Sacred Heart Hospital, Gyeonggi, South Korea
e-mail: jhj1229@hallym.or.kr
© The Author(s), under exclusive license to Springer Nature Singapore Pte
Ltd. 2025
J.-J. Park etal. (eds.), Balloon-Assisted Enteroscopy,
https://doi.org/10.1007/978-981-95-2445-7_1
*)
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