Whole colonic EUS with use of a novel device: invivo animal study.

Abstract

A prototype endoscope accessory device (SpliTube; SanitizAir Inc, Irvine, CA) has been created by use of an overtube with a longitudinal closable seam (Fig. 1A) equipped with a positioning balloon, an occlusion balloon (Figs. 1B and 1C), and a sealing balloon (Fig. 1D) that allows the creation of a working compartment within the GI tract (Fig. 1E). SpliTube does not need preloading on the colonoscope before intubation and permits exchange of the colonoscope with an echoendoscope. The created compartment at the tip of the echoendoscope can be filled with water, which facilitates acoustic coupling of the echoendoscope with the wall of the colon and surrounding organs for creation of complete 360° EUS images (Video 1, available online at www.VideoGIE.org). For this specific application, the outer size of overtube was 22 mm, the total length was 36 inches, and the weight was 135 g. The allowed inflated diameter of the positioning balloon and occlusion balloon was 60 mm (the balloons could be safely expanded to 100 mm in diameter ex vivo). In a porcine model and after the administration of adequate sedation, an adult colonoscope was inserted into the colon and was advanced to the proximal colon. The new endoscope accessory was applied to the colonoscope (Fig. 1F), and with the use of 2 balloons, a dynamic compartment was created (Fig. 1G). The colonoscope was then substituted with an echoendoscope. The entire compartment along with the echoendoscope could be moved along the colon without changing its elements while EUS images were obtained (Fig. 1H). We have shown that EUS evaluation of the colon and surrounding tissue was technically feasible and safe in a live porcine model. The clinical impact of the proposed device is not limited to performing EUS in the intestinal tract, but the new endoscope accessory can provide an on-demand overtube that can provide an isolated compartment within the GI tract for a variety of applications. This would allow an exchange of endoscopes without the need for reintubation and also provide a stable environment for performing procedures in an isolated section of the gut. Dr Farhadi is founder and owner of SanitizAir Inc. Mr Saadat and Mr Ewer are engineers and consultants for SanitizAir Inc. The authors disclosed no other financial relationships relevant to this publication. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI3MGU0MjE5ZTUxOWU1MmM0NGNlMzJiODExNGJmNzc0MCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc5NDEzODg4fQ.Rf3fWcy3BfNIlJY9MILFgDTCdcneo6E_xF-I6ypGeU5P85f4VYbETF6urZxX2KMsPQ0jODa1SPG8_XEviMLHw5d-bzPQoB6A8ezODRw2b5bkpHEEsnR03ark30Vpnb_eJjKHhiwhxAzGseXhl0eADp0IWmmvaoqiitSGKG3Ce4L5eUR6CBLB1Fw45iWZNbZkviMU-81uYi8LLL3qBikiLImvyueOKj2Al7fiWBCuHwfi2d-icLqcrniu-ZEw47cG3eJO0eaZPeYC3EiXILWjnPjTEcPDSYj30hHu6v5plJ3y67iZ_8_mLRKynhqbLDPIBFBMA1X88i5bXBTVCTPPZA Download .mp4 (97.56 MB) Help with .mp4 files Video 1Whole colonic EUS in porcine model. Download .docx (.01 MB) Help with docx files Video Script