Equipment in Pediatric Endoscopy

  • Maria Teresa Illiceto
  • Gabriele Lisi
  • Giuliano LombardiEmail author


With the development of a sub-specialty focused on pediatric gastrointestinal disorders, new technologies such as pediatric endoscopy were developed for diagnostic and therapeutic aims. Current endoscopic technology permits safe visualization, tissue sampling, and therapeutic procedures. Outer tip and working channel diameters have the greatest importance in the selection of an endoscope for the smaller children. The use of a smaller endoscope could represent the limiting element for the use of accessories, which are needed primarily for therapeutic purposes. Gastroscopes with outer diameters ranging from 4.9 to 12.8 mm are at present available, and colonoscopes range from 9.8 to 13.3 mm. Working channel diameters range from 1.5 mm of the slimmest instruments up to 4.2 mm of the largest adult therapeutic endoscopes. In 2017, the European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) published the executive summary of the Guideline on pediatric gastrointestinal endoscopy that refers to infants, children, and adolescents aged 0–18 years.

Furthermore, for most pediatric endoscopists, the choice of the instrument is based on the age and weight of the patient, on their personal experience and preference, considering the diagnostic or therapeutic procedure to be performed.


Endoscopic pediatric equipment Endoscope choice 


  1. 1.
    Fox VL. Pediatric endoscopy. In: Classen M, Tytgat GNJ, Lightdale CJ, editors. Gastroenterology endoscopy. Stuttgart, Germany/New York: Thieme; 2002. p. 720–52.Google Scholar
  2. 2.
    ASGE Technology Committee. Status evaluation report equipment for pediatric endoscopy. Gastrointest Endosc. 2012;76(1):8–17.CrossRefGoogle Scholar
  3. 3.
    Rodriguez SA, Banerjee S, Desilets D, et al. Ultrathin endoscopes. Gastrointest Endosc. 2010;71:893–8.CrossRefGoogle Scholar
  4. 4.
    Benaroch LM, Rudolph CD. Introduction to pediatric esophagogastroduodenoscopy and enteroscopy. Gastrointest Endosc. 2010;71:893–8.CrossRefGoogle Scholar
  5. 5.
    Schappi MGMJ, Mougenot J-F, Belli DC, et al. Upper gastrointestinal endoscopy. In: Kleinman R, Olivier G, Miele-Vergani G, et al., editors. Walker’s pediatric gastrointestinal disease: physiology, diagnosis, management, vol. 2. 5th ed. Decker: Hamilton, ON, Canada; 2008. p. 1265–83.Google Scholar
  6. 6.
    North American Society for Pediatric Gastroenterology, Hepatology and Nutrition; and American Society for Gastrointestinal Endoscopy. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2008;67:1–9.CrossRefGoogle Scholar
  7. 7.
    Thomson M. Colonoscopy and enteroscopy. Gastrointest Endosc Clin N Am. 2001;11:603–39, vi.PubMedGoogle Scholar
  8. 8.
    de’Angelis GL, Fornaroli F, et al. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenter. 2007;102:1749–57.CrossRefGoogle Scholar
  9. 9.
    Zevit N, Shamir R. Wireless capsule endoscopy of the small intestine in children. J Pediatr Gastroenterol Nutr. 2015;60:696–701.CrossRefGoogle Scholar
  10. 10.
    Seidman EG, Sant’Anna AM, Dirks MH. Potential applications of wireless capsule endoscopy in the pediatric age group. Gastrointest Endosc Clin N Am. 2004;14:207–17.CrossRefGoogle Scholar
  11. 11.
    Guilhon de Araujo Sant’Anna AM, Dubois J, Miron MC, et al. Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial. Clin Gastroenterol Hepatol. 2005;3:264–70.CrossRefGoogle Scholar
  12. 12.
    Antao B, Bishop J, Shawis R, et al. Clinical application and diagnostic yield of wireless capsule endoscopy in children. J Laparoendosc Adv Surg Tech A. 2007;17:364–70.CrossRefGoogle Scholar
  13. 13.
    Fritscher-Ravens A, Scherbakov P, Bufler P, et al. The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicenter European study. Gut. 2009;58:1467–72.CrossRefGoogle Scholar
  14. 14.
    Nuutinen H, Kolho KL, Salminem P, Rintala R, et al. Capsule endoscopy in pediatric patients: technique and results in our first 100 consecutive children. Scandin J Gastroenterol. 2011;46(9):1138–43.CrossRefGoogle Scholar
  15. 15.
    Jensen MK, Tipnis NA, Bajorunaite R, et al. Capsule endoscopy performed across the pediatric age range: indications, incomplete studies and utility in management of inflammatory bowel disease. Gastrointest Endosc. 2010;72:95–102.CrossRefGoogle Scholar
  16. 16.
    Thomson M, Fritscher-Ravens A, Mylonaki M, Swain P, et al. Wireless capsule endoscopy in children: a study to assess diagnostic yield in small bowel disease in paediatric patients. J Ped Gastroenterol Nutr. 2007;44(2):192–7.CrossRefGoogle Scholar
  17. 17.
    Spada X, Hasan C, et al. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2012;44(5):527–36.CrossRefGoogle Scholar
  18. 18.
    Barth BA. Enteroscopy in children. Curr Opin Pediatr. 2011;23(5):530–4.CrossRefGoogle Scholar
  19. 19.
    Yokohama K, Yano T, Kumagai H, et al. Double-balloon enteroscopy for pediatric patients: evaluation of safety and efficacy in 257 cases. J Pediatr Gastroenterol Nutr. 2016;63(1):34–40.CrossRefGoogle Scholar
  20. 20.
    Thomson M, Venkatesh K, et al. Double balloon enteroscopy in children: diagnosis, treatment and safety. World J Gastroenterol. 2010;16(1):56–62.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Barth BA, Channabasappa N. Single-balloon enteroscopy in children: initial experience at a pediatric center. J Pediatr Gastroenterol Nutr. 2010;51:680–4.CrossRefGoogle Scholar
  22. 22.
    Oliva S, Pennazio M, et al. Capsule endoscopy followed by single balloon enteroscopy in children with obscure gastrointestinal bleeding: a combined approach. Dig Liver Dis. 2015;47(2):125–30.CrossRefGoogle Scholar
  23. 23.
    Kramer RE, Brumbaugh DE, Soden JS, et al. First successful antegrade single-balloon enteroscopy in a 3-year-old with occult GI bleeding. Gastrointest Endosc. 2009;70:546–9.CrossRefGoogle Scholar
  24. 24.
    Rosen JD, Lane RS, Mrtinez JM, et al. Success and safety of endoscopic retrograde cholangiopancreatography in children. J Pediatr Surg. 2017;52(7):1148–51.CrossRefGoogle Scholar
  25. 25.
    Tringali A, Thomson M, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guideline executive summary. Endoscopy. 2017;49(1):83–91.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Patel S, Marshak J, et al. The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population. World J Pediatr. 2017;13(4):300–6. Scholar
  27. 27.
    Mahajan R, Simon EG, et al. Endoscopic ultrasonography in pediatric patients—experience from a tertiary care center in India. Indian J Gastroenterol. 2016;35(1):14–9.CrossRefGoogle Scholar
  28. 28.
    Lakhole A, Liu QY. Role of endoscopic ultrasound in pediatric disease. Gastrointest Endosc Clin N Am. 2016;26(1):137–53.CrossRefGoogle Scholar
  29. 29.
    Diehl DL, Adler DG, et al. Endoscopic retrieval devices. Gastrointest Endosc. 2009;69:997–1003.CrossRefGoogle Scholar
  30. 30.
    McKiernan PJ, Beath SV, Davison SM, et al. A prospective study of endoscopic esophageal variceal ligation using a multiband ligator. J Pediatr Gastroenterol Nutr. 2002;34:207–11.CrossRefGoogle Scholar
  31. 31.
    Gershman G, Thomson M. Therapeutic upper GI endoscopy. In:Practical pediatric gastrointestinal endoscopy. 2nd ed. Oxford, UK: Wiley-Blackwell. p. 82–92.CrossRefGoogle Scholar
  32. 32.
    Paganelli M, Alvarez F, et al. Use of hemospray for non-variceal esophageal bleeding in an infant. J Hepatol. 2014;61(3):712–3.CrossRefGoogle Scholar
  33. 33.
    Prei JC, Barmeyer C, et al. EndoClot Polysaccharide Hemostatic System in nonvariceal gastrointestinal bleeding: results of a prospective multicenter observational pilot study. J Clin Gastroenterol. 2016;50(10):e98–e100.CrossRefGoogle Scholar
  34. 34.
    Bustamante-Balén M, Plumé G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World J Gastrointest Pathophysiol. 2014;5(3):284–92.CrossRefGoogle Scholar
  35. 35.
    Antoniou D, Soutis M, Christopoulos-Geroulanos G. Anastomotic strictures following esophageal atresia repair: a 20-year experience with endoscopic balloon dilatation. J Pediatr Gastroenterol Nutr. 2010;51:464–7.CrossRefGoogle Scholar
  36. 36.
    Christopoulos-Geroulanos G. Experience with esophageal dilatations in children. Ann Gastroenterol. 2003;16(2):151–4.Google Scholar
  37. 37.
    ASGE Standard of Practice Committee. Guideline: the role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015;81(5):1101–21.CrossRefGoogle Scholar
  38. 38.
    Romeo E, Foschia F, de Angelis P, et al. Endoscopic management of congenital esophageal stenosis. J Pediatr Surg. 2011;46(5):838–41.CrossRefGoogle Scholar
  39. 39.
    Saleem MM. Acquired oesophageal strictures in children: emphasis on the use of string-guided dilatations. Singap Med J. 2009;50:82–6.Google Scholar
  40. 40.
    Dall’Oglio L, Caldaro T, Foschia F, et al. Endoscopic management of esophageal stenosis in children: new and traditional treatments. World J Gastrointest Endosc. 2016;8(4):212–9.CrossRefGoogle Scholar
  41. 41.
    Pastor AC, Mills J, Marcon MA, et al. A single center 26-year experience with treatment of esophageal achalasia: is there an optimal method? J Pediatr Surg. 2009;44:1349–54.CrossRefGoogle Scholar
  42. 42.
    Caldaro T, Torroni F, De Angelis P, et al. Dynamic esophageal stents. Dis Esophagus. 2013;26:388–91.CrossRefGoogle Scholar
  43. 43.
    Best C, Sudel B, Foker JE, et al. Esophageal stenting in children: indications, application, effectiveness and complications. Gastrointest Endosc. 2009;70:1248–53.CrossRefGoogle Scholar
  44. 44.
    Broto J, Asensio M, Vernet JM. Results of a new technique in the treatment of severe esophageal stenosis in children: poliflex stents. J Pediatr Gastroenterol Nutr. 2003;37:203–6.CrossRefGoogle Scholar
  45. 45.
    Gebrail R, Absah I. Successful use of esophageal stent placement to treat a postoperative esophageal stricture in a toddler. ACG Case Rep J. 2014;2(1):61–3.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maria Teresa Illiceto
    • 1
  • Gabriele Lisi
    • 2
  • Giuliano Lombardi
    • 1
    Email author
  1. 1.Pediatric Digestive Endoscopy and Gastroenterology Unit, Department of Pediatrics“Santo Spirito” HospitalPescaraItaly
  2. 2.Pediatric Surgery Unit, Department of Aging ScienceUniversity “G. d’Annunzio”Chieti-PescaraItaly

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