Performing Double-Balloon Enteroscopy: The Utility of the Erlangen EndoTrainer

Double-balloon enteroscopy (DBE) is now an established method for endoscopic visualization of the deep small bowel. DBE is not only a diagnostic tool, but also makes it possible to take biopsy samples and perform endoscopic therapeutic interventions. However, DBE is a complex examination and should therefore only be performed by experienced endoscopists after appropriate training. The best method of teaching DBE and improving the acquisition of competence appears to be through step-by-step training. Lectures and videos are very useful during the initial steps, whereas hands-on training with animal models and demonstration of live DBE procedures are the main components used for providing training in and teaching of DBE. Ex vivo pig models, such as the modified Erlangen EndoTrainer, are useful methods to teach DBE.