Technical Feasibility of a Guidetube for Various Endoscopic Procedures in Human Gastrointestinal Simulators
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Many gastrointestinal (GI) endoscopic procedures are difficult and cumbersome owing to the limitation ofcurrently available endoscopic devices. This study aimed to develop an endoscopic guidetube for multipurpose endoscopic proceduresand assess its use in a realistic GI endoscopic simulator. Methods: The guidetube used is a soft overtube composed of neoprene and is designed to assist various endoscopic procedures ondemand. In total, 15 types of procedures were performed in GI simulators. Four procedures were performed in the stomach model and11 in the colon model. The procedures include repeated endoscopic insertion and foreign body removal in various positions. The meaninsertion and procedure time were assessed in each session. All procedures were performed by 5 expert endoscopists. Results: Endoscopic procedures with the new guidetube were faster and more effective than the conventional endoscopic techniques. The mean insertion time of the endoscope with the guidetube was significantly shorter than that without the guidetube. The guidetubewas safely inserted without scratch using low pushing force. Objects of various sizes larger than the endoscopic channel were easilyremoved by the guidetube-assisted endoscopic procedures. Conclusions: This preliminary study shows that guidetube-assisted endoscopic procedures are faster, easier, safer and cheaper thanconventional endoscopic procedures.
Abstract
Background/Aims: Many gastrointestinal (GI) endoscopic procedures are difficult and cumbersome owing to the limitation ofcurrently available endoscopic devices. This study aimed to develop an endoscopic guidetube for multipurpose endoscopic proceduresand assess its use in a realistic GI endoscopic simulator. Methods: The guidetube used is a soft overtube composed of neoprene and is designed to assist various endoscopic procedures ondemand. In total, 15 types of procedures were performed in GI simulators. Four procedures were performed in the stomach model and11 in the colon model. The procedures include repeated endoscopic insertion and foreign body removal in various positions. The meaninsertion and procedure time were assessed in each session. All procedures were performed by 5 expert endoscopists. Results: Endoscopic procedures with the new guidetube were faster and more effective than the conventional endoscopic techniques. The mean insertion time of the endoscope with the guidetube was significantly shorter than that without the guidetube. The guidetubewas safely inserted without scratch using low pushing force. Objects of various sizes larger than the endoscopic channel were easilyremoved by the guidetube-assisted endoscopic procedures. Conclusions: This preliminary study shows that guidetube-assisted endoscopic procedures are faster, easier, safer and cheaper thanconventional endoscopic procedures.
참고문헌 (19)
- Birk M, "Removal of foreign bodies in the upper gastrointestinal tract in adults : European Society of Gastrointestinal Endoscopy(ESGE)clinical guideline", Endoscopy, 48, pp.489~496 (2016)
- Seri Hong, "Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey", Gut and Liver, 12(4), pp.426~432 (2018), 거트앤리버 소화기연관학회협의회
- Uraoka T, "Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum", Gut, 55, pp.1592~1597 (2006)
- Edris Wedi, "Full-Thickness Resection Device for Complex Colorectal Lesions in High-Risk Patients as a Last-Resort Endoscopic Treatment: Initial Clinical Experience and Review of the Current Literature", Clinical Endoscopy, 51(1), pp.103~108 (2018), 대한소화기내시경학회
- Winawer SJ, "Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup", N Engl J Med, 329, pp.1977~1981 (1993)
- Klein A, "Advanced polypectomy and resection techniques", Gastrointest Endosc Clin N Am, 25, pp.303~333 (2015)
- 이상표, "Risk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy", Gut and Liver, 9(1), pp.66~72 (2015), 거트앤리버 소화기연관학회협의회
- Goldschmiedt M, "A safety maneuver for placing overtubes during endoscopic variceal ligation", Gastrointest Endosc, 38, pp.399~400 (1992)
- Hawari R, "Going for the loop : a unique overtube for the difficult colonoscopy", J Clin Gastroenterol, 41, pp.138~140 (2007)
- Raju GS, "ShapeLock : a rapid access port for redeployment of a colonoscope into the proximal colon to facilitate multiple polypectomies in a single session", Gastrointest Endosc, 61, pp.768~770 (2005)
- Shin JS, "Longitudinal linear-incised overtube for endoscopic removal of larger ingested foreign bodies", Gastrointest Endosc, 41, pp.618~ (1995)
- ASGE Technology Committee, "Overtube use in gastrointestinal endoscopy", Gastrointest Endosc, 70, pp.828~834 (2009)
- Berkelhammer C, ""Pinch"injury during overtube placement in upper endoscopy", Gastrointest Endosc, 39, pp.186~188 (1993)
- Dinning JP, "Delayed presentation of esophageal perforation as a result of overtube placement", J Clin Gastroenterol, 24, pp.250~252 (1997)
- el-Newihi HM, "Esophageal perforation as a complication of endoscopic overtube insertion", Am J Gastroenterol, 89, pp.953~954 (1994)
- Groenen MJ, "Acute pancreatitis after double-balloon enteroscopy : an old pathogenetic theory revisited as a result of using a new endoscopic tool", Endoscopy, 38, pp.82~85 (2006)
- Holderman WH, "Endoscopic findings and overtube-related complications associated with esophageal variceal ligation", J Clin Gastroenterol, 21, pp.91~94 (1995)
- Jeffries MA, "Overtube separation", Gastrointest Endosc, 47, pp.435~436 (1998)
- Levy R, "Separation of an overtube from the bite block during band ligation of esophageal varices", Gastrointest Endosc, 46, pp.66~68 (1997)