{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:33:33Z","timestamp":1767339213442,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Conventional colonoscopy (CC) allows access for colonic investigation and intervention; in the small group in whom CC is unsuccessful alternative imaging is often sufficient. There remains a subset, however, requiring full colonic visualisation or intervention. Balloon-assisted colonoscopy (BAC) gives a further option when access is difficult. Aims: This study aims to present the experience with BAC of two European tertiary referral centres. Methods: Procedures were carried out under local protocol over 15-years (2006\u20132020). Markers of procedural quality such as caecal intubation, complications and comfort were retrospectively compiled and analysed. Published evidence was summarised for comparison. Results: 122 procedures were undertaken, with polyps the most frequent indication and 90.2% having at least one previously incomplete CC. Features associated with difficult colonoscopy were common, including intraabdominal surgery (32.0%). 92.6% reached the caecum; completion was higher (96.3%) in those failing CC due to discomfort and lower in those failing due to anatomical difficulties (90.7%) or previous surgery (84.6%). Mean time to the caecum was 20.9 minutes and mean midazolam and fentanyl doses were 2.6 mg and 49.9 \u00b5g with low discomfort scores. Conclusion(s): Balloon-assisted colonoscopy is successful in &gt;90% of patients, is well-tolerated, and is safe.<\/jats:p>","DOI":"10.3390\/jcm9092981","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T10:24:09Z","timestamp":1600165449000},"page":"2981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Balloon-Assisted Colonoscopy after Incomplete Conventional Colonoscopy\u2014Experience from Two European Centres with A Comprehensive Review of the Literature"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-9254","authenticated-orcid":false,"given":"Robertson","family":"Alexander R","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Western General Hospital, Edinburgh EH4 2XU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2248-489X","authenticated-orcid":false,"given":"Koulaouzidis","family":"Anastasios","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung","family":"Diana E","sequence":"additional","affiliation":[{"name":"Centre for Liver &amp; Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fraser","family":"Christopher","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nemeth","family":"Artur","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Skane University Hospital, Lund University, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trimble","family":"Kenneth","sequence":"additional","affiliation":[{"name":"Centre for Liver &amp; Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-9239","authenticated-orcid":false,"given":"Toth","family":"Ervin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Skane University Hospital, Lund University, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-8778","authenticated-orcid":false,"given":"Plevris","family":"John N","sequence":"additional","affiliation":[{"name":"Centre for Liver &amp; Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-4369","authenticated-orcid":false,"given":"Wurm Johansson","family":"Gabriele","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Skane University Hospital, Lund University, 205 02 Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0016-5085(19)35579-9","article-title":"Demonstration of a new gastroscope, the fiberscope","volume":"35","author":"Hirschowitz","year":"1958","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/S0016-5085(75)80250-2","article-title":"Colonoscopy: A Review","volume":"68","author":"Overholt","year":"1975","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1136\/gutjnl-2016-312044","article-title":"UK key performance indicators and quality assurance standards for colonoscopy","volume":"65","author":"Rees","year":"2016","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1055\/s-0043-103411","article-title":"Performance measures for lower gastrointestinal endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative","volume":"49","author":"Kaminski","year":"2017","journal-title":"Endoscopy"},{"key":"ref_5","first-page":"882","article-title":"Response: Gastrointest","volume":"84","author":"Rex","year":"2016","journal-title":"Endoscopy"},{"key":"ref_6","first-page":"31","article-title":"Colon capsule endoscopy vs. CT-colonography in the evaluation of patients with incomplete colonoscopy","volume":"28","author":"Spada","year":"2013","journal-title":"J. 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