Practical Gastroenterology and Hepatology Board Review Toolkit

Nicholas J. Talley , Kenneth R. Devault, Michael B. Wallace, Bashar A. Aqel, Keith D. Lindor


97.1 Animated video of how to perform an antegrade double balloon enteroscopy

  • With both balloons deflated, endoscope and overtube are advanced to the duodenum. (Avoid inflating the balloons in the area of the ampulla because trauma or duodenal hypertension may cause pancreatitis.)
  • The balloon on the overtube is inflated and holds the overtube stationary while the endoscope is advanced to its maximal extent.
  • The balloon at the end of the endoscope is then inflated while the balloon on the overtube is deflated. The overtube is advanced to the distal end of the endoscope when the overtube balloon is inflated. The balloons now approximate each other.
  • The endoscopist then gently withdraws the overtube and the endoscope together, allowing the intestine to be pleated over the overtube.
  • The balloon at the tip of the endoscope is then deflated, followed by advancement of the endoscope. The sequence is repeated until the desired depth of insertion is reached or the scope cannot be advanced further.

(With permission of Mayo Foundation for Medical Education and Research.)