Modified single-operator method for double-balloon endoscopy.

Applications of double-balloon endoscopy (DBE) have expanded widely to areas beyond small-intestine endoscopy. Two endoscopists are required for standard insertion, but it is preferable to have DBE carried out by one endoscopist to optimize control of the procedure and because of human resources issues. We previously reported on the Single-Operator Method, but here we describe newly modified insertion techniques that facilitate and enhance the performance of DBE by a single endoscopist. Our new technique consists of Hooking Technique, Outside Support, Grasp Scope and Overtube, Continuous Overtube Infusion and Double-Overtube Method. These new techniques make it easier to carry out the Single-Operator Method.