Dr Edward Despott and team perform double balloon enteroscopyThe Royal Free Hospital has become only the second hospital in London to introduce a revolutionary procedure for the investigation and treatment of small bowel disease. Double-balloon enteroscopy (DBE) allows doctors to examine and treat parts of the small bowel which are usually impossible to reach without surgery. 
The technology was funded by a grant of £65,000 from the Royal Free Charity. Chris Burghes, chief executive of the Royal Free Charity, said: “We support initiatives that improve services, facilities and the environment for patients and staff at the Royal Free and DBE is a prime example of this. The Royal Free Hospital is only the second hospital in London, after St Mark’s Hospital in Harrow, to use DBE to investigate and treat small bowel disease.”
The small bowel is the longest part of the intestine, approximately six metres in length. Due to its length and ‘coiled up’ nature, it has until recently been difficult for doctors to examine and treat the small bowel without surgery. The DBE features two balloons which, when inflated with air, lightly support the small bowel. This allows a long, slim camera tube (enteroscope) to be gently advanced within it in a caterpillar-like fashion.
Dr Edward Despott, a consultant gastroenterologist at the Royal Free Hospital who undertook more than three years of dedicated DBE training at St Mark’s Hospital in Harrow, said: “In recent years, the investigation and management of small bowel disease has been revolutionised by the introduction of DBE. This is very much a cutting-edge procedure which allows us to take samples and apply therapy deep within the small bowel in a minimally invasive way.

”In order to maximise patient comfort, DBE is performed under deep sedation or general anaesthesia. The procedure usually takes about 90 minutes to perform and the patient will generally be discharged home on the same day.
“The benefits of DBE include its ability to allow examination of parts of the small bowel that are usually impossible to reach without surgery, to further investigate and biopsy abnormalities which have been seen on scans or at capsule endoscopy, to evaluate the effects of medication and to apply therapy.”

Photo: (back row, L-R) Emmanuelle Bediat, endoscopy healthcare assistant; Ghassan El-Sayed, gastroenterology specialist registrar; Tom Shepherd, gastroenterology specialist registrar; Sanjeeva Korala, endoscopy charge nurse; Scott Bromily, technical specialist, Imotech Medical; (front row) Dr Edward Despott, consultant gastroenterologist.