BACKGROUND: Catheter/guidewire exchanges during ERCP require the coordinated efforts of an endoscopist and endoscopy assistant. A prototype duodenoscope was developed to improve the control of catheter/guidewire exchange by enabling fixation of guidewires at the elevator lever. METHODS: An initial prototype duodenoscope and a subsequent modification of this instrument were used to perform ERCP in 7 and 10 patients, respectively. The following were recorded: total procedure time, fluoroscopy time, catheter/guidewire exchange time, guidewire repositioning, loss of guidewire access, success or failure of fixation, and endoscopist satisfaction. OBSERVATIONS: The initial and the modified prototype duodenoscopes were used in a variety of catheter/guidewire exchanges (n=46). Guidewire fixation was achieved in 75% of catheter/guidewire exchanges with the initial prototype and in 93% with the modified prototype and was reflected in shorter exchange times. Access to the desired duct was not lost during any exchange, and the need for repositioning was eliminated. CONCLUSIONS: A new prototype duodenoscope with an elevator lever that enables guidewire fixation will improve the ease and efficiency of catheter/guidewire exchange during ERCP. Modifications made to the original prototype improved reliability of guidewire fixation.
BACKGROUND: Catheter/guidewire exchanges during ERCP require the coordinated efforts of an endoscopist and endoscopy assistant. A prototype duodenoscope was developed to improve the control of catheter/guidewire exchange by enabling fixation of guidewires at the elevator lever. METHODS: An initial prototype duodenoscope and a subsequent modification of this instrument were used to perform ERCP in 7 and 10 patients, respectively. The following were recorded: total procedure time, fluoroscopy time, catheter/guidewire exchange time, guidewire repositioning, loss of guidewire access, success or failure of fixation, and endoscopist satisfaction. OBSERVATIONS: The initial and the modified prototype duodenoscopes were used in a variety of catheter/guidewire exchanges (n=46). Guidewire fixation was achieved in 75% of catheter/guidewire exchanges with the initial prototype and in 93% with the modified prototype and was reflected in shorter exchange times. Access to the desired duct was not lost during any exchange, and the need for repositioning was eliminated. CONCLUSIONS: A new prototype duodenoscope with an elevator lever that enables guidewire fixation will improve the ease and efficiency of catheter/guidewire exchange during ERCP. Modifications made to the original prototype improved reliability of guidewire fixation.
Authors: Peter V Draganov; Lukasz Kowalczyk; Ali Fazel; Koorosh Moezardalan; Jen-Jung Pan; Chris E Forsmark Journal: Dig Dis Sci Date: 2010-02 Impact factor: 3.199
Authors: Martin Raithel; Andreas Nägel; Jürgen Maiss; Dane Wildner; Alexander Fritzkarl Hagel; Sandra Braun; Hiwot Diebel; Eckhart Georg Hahn Journal: World J Gastroenterol Date: 2013-03-28 Impact factor: 5.742