You can use this guide to help you identify and resolve basic errors you may be experiencing with Crospon’s diagnostic and therapeutic technologies – the Endoflip® Imaging System and Esoflip® balloon catheters. If your issue is more detailed and has not been covered here, please contact by email or 1-855-CROSPON (US) or +353-91-519880 (ROW) for further help.

 Trouble Shooting Guide

Catheter not recognised / EEPROM/ Catheter not supported in this software release error messages

This could be caused by some dust on one of the catheter connector pins. Un-plug the grey catheter connector from the Endoflip unit and examine the catheter connector pins, wipe with an IPA swab if they do not look clean. Reinsert the connector a few times.

Plunger does not align correctly

Make sure the green dot on the grey catheter connector body is pointing upwards when inserted. There is a matching green dot on the Endoflip® unit. Once you plug in the grey catheter connector with the green dot showing on the top, the machine will automatically move the plunger to the correct position after you press the Continue button

Pre-use check fail

First assess if it is an insignificant error e.g. 12.9 versus 13mm or 15.1 versus the 15mm, the permissible test levels for the 14mm metal tube. In such instances, with the balloon in the metal tube, do a manual inflate to 19cc for the EF325N, ES320 and ES330 or to 29cc for the longer EF322N and see that the diameters are reading 14+/- 1mm.

Pressure zeroing (Endoflip® Diagnostic probes only)

It is advisable to let the catheter warm up after connecting to the machine for about 10 minutes to minimize pressure sensor drift. It is recommended to pressure zero with the balloon laying horizontal on the preparation area, and just before inserting the catheter into the patient.

Should you disconnect wall power accidentally

If there is more than 10ml in syringe, re-connect the wall power and hit the Continue button. However, if there is less than 10ml in the balloon, you will need to remove the syringe and pull back the plunger to the arrow position. Proceed through the normal start-up sequence. There is no need to re-purge i.e. hit the Continue button when asked if you wish to purge.

Loud crunching noise from the system

Press the Stop button immediately and deflate to 0ml. Remove the red cap from the syringe and connect the catheter fill tube to the syringe. Remove the syringe and catheter connector from the unit and restart the unit. Re-connect the catheter and syringe as normal.

Dilator Protocols

Top Tips – Endoflip®
  1. Whereas most users deploy the Endoflip® catheter by advancing it alongside the endoscope, there are two models of endoscope with sufficiently large channels to allow introduction of the catheters through the scope: the Olympus GIF-XT-30 and GIF-XTQ160. These endoscopes are particularly useful when performing measurements of the pylorus.
  2. Typically, the Endoflip® catheter is deployed alongside the endoscope, much like an achalasia dilator balloon. An alternative approach is you can place the tip in the working channel of an endoscope, the endoscope may be used to steer the catheter. This is particularly useful for deployment of the catheter into the pylorus.
Typical Values commonly seen with 30ml in the Endoflip EF-325N balloon at the GEJ.
Distensibility (mm2/mmHg)
1 Achalasia1,2,3
2 Tight/GEJ outflow obstruction. Clinical evidence suggests that many Nissen fundoplications are at this
level immediately post-op, but relax over the ensuing 6 months
3-5 Normal
5-8 Loose4 – this is the target range in POEM. We would suggest 40ml in the balloon for this particular measurement
Diameter (mm)
4-51,2,3 Achalasia
7 Normal
10+4,5 Loose
  1. Rohof et al Gastroenterology 2012;143:328–335
  2. Pandolfino et al Neurogastroenterol Motil. 2013 Jun;25(6):496-501
  3. Verlaan et al Gastrointest Endosc. 2013 Jul;78(1):39-44
  4. Teitelbaum et al Surg Endosc. 2015 Mar;29(3):522-8
  5. Ngamruengphon et al Surg Endosc. 2016 Jul;30(7):2886-94
Stricture Dilation with 20mm Esoflip® (ES-320 balloon)
  1. Set the balloon inflation setting on the machine to max volume
  2. Introduce catheter alongside scope placing the balloon into body of stricture (or distal to the stricture)
  3. Inflate to 20ml to measure pre-dilation stricture diameter
  4. Pull back or push forward to center balloon in stricture
  5. Initially inflate to desired inflation diameter (Hit Stop button when 2mm below target diameter to allow for syringe-balloon pressure equalization and thereafter inflate further in small increments as required)
  6. Hold for 2 min
  7. Reduce balloon volume to 20ml and measure waist
  8. Inflate further if required, and repeat as necessary to achieve desired post-dilation diameter.
Esoflip® 30mm dilation for achalasia (ES-330 balloon)
  1. 1. Set the balloon inflation setting on the machine to max volume.
  2. Introduce the catheter alongside the scope to place the balloon into stomach.
  3. Inflate to 30ml.
  4. Pull back to place the balloon into the center of the GEJ. Typically bad achalasic patients have a GEJ waist diameter around 9mm, less severe can be up to 11mm as measured with the ES-330 catheter.
  5. Inflate to effacement (or to 20/25/30 mm depending on how conservative you want to be) while holding the balloon in position.
  6. Hold for 2 min.
  7. Reduce balloon volume to 30ml and measure waist again.
  8. If above 16mm waist, you have likely achieved an adequate dilation (20mm is excellent). If below 16mm, increase diameter and repeat steps 5 to 7, or if you have just completed a 30mm dilation, repeat steps 5 to 7.