Intraoperative endoscopy.

Intraoperative endoscopy (IOE) is accepted as the ultimate diagnostic procedure for the complete evaluation of small bowel. Until recent years, operative endoscopy was the complement of sonde enteroscopy. The difficulties of this long and fastidious type of examination, for both the patient and the medical team are well known. It provides incomplete exploration (detubing of certain loops is too rapid), and renders impossible any diagnostic or therapeutic procedure (biopsies, electrocoagulation). The indications of IOE have diminished over recent years during the development of push enteroscopy by upper or double way. Indeed, the latter method makes it possible in a number of cases to obtain complete exploration of the small bowel with biopsies and therapeutic procedures, or an exploration enabling screening for lesions in the first jejunal loops of the lat ileal loops.