A Pini Prato1, G Martucciello, V Jasonni. 1. Department and Chair of Pediatric Surgery, Giannina Gaslini Institute, University of Genova, Italy.
Abstract
BACKGROUND/ PURPOSE: Preoperative histochemistry on rectal mucosal-submucosal specimens is the most important step in the diagnosis of Hirschsprung's disease and other dysganglionoses. Today, rectal mucosal-submucosal biopsy specimens are obtained by suction with the widely used tool first designed by Noblett in the late 1960s. The authors developed a new instrument, for which a patent has already been filed, for one-hand execution of rectal suction biopsies, which will make this operation easier and faster. METHODS: The authors modified the old tool but maintained the cutting method described by Noblett. The authors' innovative automatic tool (Solo-RBT) is based on the possibility of sequencing suction and cutting of the rectal mucosa just by pressing a "trigger." The trigger activates a plunger to obtain the vacuum necessary for the suction and a cutter for mucosal sampling. To perform a correct biopsy in children with different weight and in adults, Solo-RBT can be adjusted suitably to obtain automatically the vacuum required in each case. Additionally, this tool is provided with 2 different sizes of both capsules and cutters, and it can be disassembled completely for easy cleaning, maintenance, and sterilization. RESULTS: The instrument was tested clinically on 62 children (189 biopsies), and it proved to be versatile, atraumatic, and extremely handy, because it can be used by just 1 physician who only needs to press the trigger to obtain the biopsy. CONCLUSIONS: Solo-RBT not only maintains the benefits (atraumatic, easy to use, rapid) and the main characteristic (cutting system) of Noblett's tool but it also improves its features and eliminates most of its disadvantages. Therefore, Solo-RBT represents a significant improvement in the diagnosis of Hirschsprung's disease and other dysganglionoses. Copyright 2001 by W.B. Saunders Company.
BACKGROUND/ PURPOSE: Preoperative histochemistry on rectal mucosal-submucosal specimens is the most important step in the diagnosis of Hirschsprung's disease and other dysganglionoses. Today, rectal mucosal-submucosal biopsy specimens are obtained by suction with the widely used tool first designed by Noblett in the late 1960s. The authors developed a new instrument, for which a patent has already been filed, for one-hand execution of rectal suction biopsies, which will make this operation easier and faster. METHODS: The authors modified the old tool but maintained the cutting method described by Noblett. The authors' innovative automatic tool (Solo-RBT) is based on the possibility of sequencing suction and cutting of the rectal mucosa just by pressing a "trigger." The trigger activates a plunger to obtain the vacuum necessary for the suction and a cutter for mucosal sampling. To perform a correct biopsy in children with different weight and in adults, Solo-RBT can be adjusted suitably to obtain automatically the vacuum required in each case. Additionally, this tool is provided with 2 different sizes of both capsules and cutters, and it can be disassembled completely for easy cleaning, maintenance, and sterilization. RESULTS: The instrument was tested clinically on 62 children (189 biopsies), and it proved to be versatile, atraumatic, and extremely handy, because it can be used by just 1 physician who only needs to press the trigger to obtain the biopsy. CONCLUSIONS: Solo-RBT not only maintains the benefits (atraumatic, easy to use, rapid) and the main characteristic (cutting system) of Noblett's tool but it also improves its features and eliminates most of its disadvantages. Therefore, Solo-RBT represents a significant improvement in the diagnosis of Hirschsprung's disease and other dysganglionoses. Copyright 2001 by W.B. Saunders Company.