Recent technological advances in device-assisted enteroscopy

Device-assisted enteroscopy (DAE) has revolutionized small bowel evaluation by allowing endoscopic access for both diagnosis and therapy. Since the introduction of double-balloon enteroscopy, newer techniques such as single-balloon enteroscopy, spiral enteroscopy (SE), and balloon-guided systems have expanded clinical options. However, conventional DAE remains limited by procedural complexity, prolonged procedure times, and incomplete enteroscopy. In response, novel technologies have emerged to improve efficiency and outcomes. Among these, motorized power SE (PSE) represents a significant advancement, enabling deeper insertion and single-operator capability. Despite promising early results, PSE has been withdrawn from the market owing to safety concerns, particularly esophageal injuries. Nevertheless, recent studies suggest that PSE may still be a valuable rescue technique in selected cases in which balloon-assisted methods fail. Additional advances, including artificial intelligence-assisted lesion detection, are being integrated into modern DAE platforms. Continued innovation in imaging, device ergonomics, and procedural safety is essential to meet the evolving clinical demands. This review highlights the recent technological progress in DAE and discusses the challenges and future directions for integrating these tools into routine practices.