Balloon Dilatation
- Esophageal Dilation Catheters
- PPDTM Progressive pressure Dilatation Catheters
- Biliary Dilatation Catheters
Balloon dilatation is one of several methods available to the Gastroenterologist for the treatment of strictures of the gastrointestinal tract. Strictures occur most commonly in the esophagus, but may also occur in the pylorus, biliary tract and colon.
Prior to the widespread acceptance of dilatation, most strictures had to be treated surgically. The first advance in dilatation come about with the development of the mercury-weighted bougie. The bougie is simply a stretching device advanced down the esophagus (the only part of the GI tract in which bougies can be used) until the stricture is opened. This type of device, while still used, is considered somewhat barbaric because of the patient discomfort it causes.
The second advance in dilatation came with the development of over-the-wire Savarytype dilator. While offering somewhat better control than the bougie, the principal employed is the same. Not surprisingly the degree of patient discomfort is also the same.
Trans-endoscopic balloon dilatation represents the most advanced method to treat strictures. A stricture is first visualized endoscopically. Then, a balloon dilatation catheter is advanced through the working channel of the endoscope until it exits the tip in the vicinity of the stricture.
The tip of the balloon dilator is advanced through the stricture and the balloon positioned so that it is centered in the stricture. The balloon is then inflated with saline solution to reach an indicated pressure. The balloon may be inflated and deflated several times to assure effective dilatation. In some cases, progressive dilatation may be employed. That is, successively larger balloons may be inflated to achieve stricture dilatation.
Most dilation procedures are for benign strictures of the esophagus which make swallowing extremely difficult. The pylorus may also stricture making emptying of the stomach difficult. Ducts of the biliary tree may stricture as a result of scarring, inflammation or cancer. And, the colon may stricture usually as a result of surgical scarring.
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