Also called push-and-pull enteroscopy or balloon-assisted enteroscopy

Mechanism:

Uses an endoscope inside an overtube, each with a balloon

Balloons alternately inflate/deflate while tubes are advanced/withdrawn

Gathers the intestine in sections (like pushing a sleeve up the arm) → allows access to deep small bowel

Approaches:

Antegrade (via mouth)

Retrograde (via colon)

Indications / Uses

Diagnose & treat conditions in the small intestine:

Removal of polyps

Detect/treat bleeding sources

Dilate strictures (narrowings)

Retrieve foreign bodies (including retained capsules)

Remove stones blocking bile duct (esp. after gastric bypass)

Take biopsies for IBD, celiac disease, tumors, etc.

Place stents to widen/open obstructed segments

Advantages

Provides direct visualization of the small bowel

Allows both diagnosis and treatment in one procedure

Complements capsule endoscopy (which is diagnostic only)

Limitations / Risks

Technically complex, requires specialized training

Longer procedure time

Risks: perforation, bleeding, pancreatitis (rare)