Abstract
As the dietary habits of Japanese have been westernizing, the number of colon cancer patients is increasing. With the advance of the instruments and techniques of colonoscopy, the success rate of cecal intubation has increased. However, total colonoscopy cannot be achieved using a standard colonoscope in some patients for various reasons. Balloon-assisted endoscopy (BAE) is very useful for those patients. There are two methods in BAE : double-balloon endoscopy (DBE) and single-balloon endoscopy (SBE). BAE was originally developed for examination of deep small intestine. However, BAE is as useful as colonoscopy. At our hospital, we select DBE for most of the patients who require BAE. For colonoscopy using BAE, good bowel preparation is desired.
Three kinds of endoscopes are available for DBE, and we use the EI-530B endoscope for most of the colonic cases. As long as DBE is performed with a good understanding of its principle, it is very useful in cases where colonoscopy would be difficult, for example, in patients with adhesion of the sigmoid colon. By using DBE, the inserting force applied to the endoscope shaft is effectively transmitted to the endoscope tip while stretching of the colon is prevented with a balloon-attached overtube. Furthermore, the double balloon endoscope can be inserted reliably with minimal pain. It is also very useful for endoscopic treatment such as endoscopic submucosal dissection (ESD) in difficult positions because stable endoscopic operation can be performed by using DBE.
