**5.2 Push enteroscopy**

Push enteroscopy is a very useful tool in the evaluation of lesion seen in the proximal part of the small bowel by VCE. Push enteroscopy is generally done by a dedicated push enteroscope (250 cm long) or a pediatric or standard colonoscope. Gastric looping and duodenal angulation prevent advancement of the scope. An overtube back-loaded on to the scope or a stiffening wire through the biopsy channel of the scope helps prevent loop formation of the scope allowing deeper

intubation of the small bowel. The actual depth of insertion of small bowel by push enteroscopy is difficult to measure but varies (120–180 cm beyond the ligament of Treitz) among endoscopists and patients [25]. Push enteroscopy has both diagnostic and therapeutic potential including biopsy, hemostasis, and tattooing [26].
