Response Letter from Green Et al.
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Dear Dr. Pawlik,
We thank Dr. Zammit and colleagues for presenting their data as it demonstrates comparable approaches to small bowel disease on both sides of the Atlantic. The numbers of small bowel capsule endoscopy that are performed are comparable. Deep enteroscopy is used as a complementary procedure and if the opportunity presents may be used therapeutically. The major problem is obscure bleeding.
Anecdotally, we have seen a similar reduction in demand for capsule endoscopy and for deep enteroscopy. This we believe is largely due to the greater availability of capsule endoscopy in the community, along with the advent of the single-balloon device (Olympus Corporation Tokyo, Japan). This requires much less of an investment than the double balloon (Fujifilm Corporation NJ, USA). Over the last decade, we have largely used the Spirus device (Olympus Corp USA) for antegrade procedures and double-balloon enteroscopy for retrograde procedures.
We have performed more intraoperative...