Push-and-pull enteroscopy: one balloon or two?

The past decade has seen several advances in small-bowel endoscopic technologies. Although the endoscopic literature is full of large case series, there are few published prospective randomized trials designed to compare any of the currently available techniques and devices for deep small-bowel endoscopy. In this edition of the American Journal of Gastroenterology, Dr May and colleagues present the results of a prospective, randomized trial comparing two techniques for performing "push-and-pull" enteroscopy: double balloon and single balloon. Although this study is not without limitations, it represents a step in the right direction toward answering several important questions that have surfaced, as techniques for deep small-bowel enteroscopy have become mainstream in endoscopic practice.