Fig. 3.

Decision on the optimal insertion direction. (A) Angulation of the small bowel loop in a U-shape around the enteroscope tip visualized with infusion of contrast dye. (B) Without straightening of the U-shape-angulated loop, the stretching of the small bowel is insignificant without advancement after pushing the scope. (C) Withdrawal of the enteroscope backward with an overtube makes the small bowel loop straighter. (D) After release of the angulated enteroscopic tip, the enteroscope and proximal side of the small bowel can be placed in a straight line, which is identical to transferring the pushing force.