Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness

Abstract Objectives Flexible endoscopy does not have a system that can automatically evacuate surgical smoke generated in the gastrointestinal lumen. We aimed to investigate the feasibility and potential usefulness of automatic smoke evacuation systems in flexible endoscopy. Methods [Bench] After su...

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Main Authors: Yohei Nose, Motohiko Kato, Shoma Aoyagi, Kazunori Akeo, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Kazuyoshi Yamamoto, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.367
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author Yohei Nose
Motohiko Kato
Shoma Aoyagi
Kazunori Akeo
Kotaro Yamashita
Takuro Saito
Koji Tanaka
Kazuyoshi Yamamoto
Tomoki Makino
Tsuyoshi Takahashi
Yukinori Kurokawa
Hidetoshi Eguchi
Yuichiro Doki
Kiyokazu Nakajima
author_facet Yohei Nose
Motohiko Kato
Shoma Aoyagi
Kazunori Akeo
Kotaro Yamashita
Takuro Saito
Koji Tanaka
Kazuyoshi Yamamoto
Tomoki Makino
Tsuyoshi Takahashi
Yukinori Kurokawa
Hidetoshi Eguchi
Yuichiro Doki
Kiyokazu Nakajima
author_sort Yohei Nose
collection DOAJ
description Abstract Objectives Flexible endoscopy does not have a system that can automatically evacuate surgical smoke generated in the gastrointestinal lumen. We aimed to investigate the feasibility and potential usefulness of automatic smoke evacuation systems in flexible endoscopy. Methods [Bench] After surgical smoke generated in the stomach was evacuated by the evacuator, the degree of residual smoke and gastric luminal collapse were evaluated to optimize the evacuator settings. [Animal] Insufflation, suction, and total operation time to complete the protocol of 10 cauterizations of the gastric mucosa were measured in three groups: “manual suction only,” “manual suction with automatic evacuation (50% force),” and “manual suction with automatic evacuation (70% force).” The stability of endoscopic visualization and operability was evaluated by 10 endoscopists blinded to those suction settings, and the number of manual suctions, insufflations, and total operation time were measured. Results [Bench] The degree of residual smoke and gastric luminal collapse were inversely correlated. [Animal] When the automatic evacuator was partially used, there was no difference in the insufflation time, but the suction time (vs 50%; p = 0.011, vs. 70%; p = 0.011) and total operation time (vs. 50%; p = 0.012, vs. 70%; p = 0.036) were significantly reduced compared to manual operation only. Furthermore, manual suction with automatic evacuation (50% force) significantly improved the stability of endoscopic visualization and operability compared to manual operation only (p = 0.041, p = 0.0085). Conclusions The automatic smoke evacuation in flexible gastrointestinal endoscopy was potentially feasible and useful by improving the device setting.
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spelling doaj-art-cb1baa3a441643aa99331259c38dca292025-08-20T03:41:00ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.367Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulnessYohei Nose0Motohiko Kato1Shoma Aoyagi2Kazunori Akeo3Kotaro Yamashita4Takuro Saito5Koji Tanaka6Kazuyoshi Yamamoto7Tomoki Makino8Tsuyoshi Takahashi9Yukinori Kurokawa10Hidetoshi Eguchi11Yuichiro Doki12Kiyokazu Nakajima13Department of Next Generation Endoscopic Intervention (Project ENGINE) Graduate School of Medicine, Osaka University Osaka JapanCenter for Diagnostic and Therapeutic Endoscopy Keio University School of Medicine Tokyo JapanAMCO Incorporated Tokyo JapanAMCO Incorporated Tokyo JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery Graduate School of Medicine Osaka University Osaka JapanDepartment of Next Generation Endoscopic Intervention (Project ENGINE) Graduate School of Medicine, Osaka University Osaka JapanAbstract Objectives Flexible endoscopy does not have a system that can automatically evacuate surgical smoke generated in the gastrointestinal lumen. We aimed to investigate the feasibility and potential usefulness of automatic smoke evacuation systems in flexible endoscopy. Methods [Bench] After surgical smoke generated in the stomach was evacuated by the evacuator, the degree of residual smoke and gastric luminal collapse were evaluated to optimize the evacuator settings. [Animal] Insufflation, suction, and total operation time to complete the protocol of 10 cauterizations of the gastric mucosa were measured in three groups: “manual suction only,” “manual suction with automatic evacuation (50% force),” and “manual suction with automatic evacuation (70% force).” The stability of endoscopic visualization and operability was evaluated by 10 endoscopists blinded to those suction settings, and the number of manual suctions, insufflations, and total operation time were measured. Results [Bench] The degree of residual smoke and gastric luminal collapse were inversely correlated. [Animal] When the automatic evacuator was partially used, there was no difference in the insufflation time, but the suction time (vs 50%; p = 0.011, vs. 70%; p = 0.011) and total operation time (vs. 50%; p = 0.012, vs. 70%; p = 0.036) were significantly reduced compared to manual operation only. Furthermore, manual suction with automatic evacuation (50% force) significantly improved the stability of endoscopic visualization and operability compared to manual operation only (p = 0.041, p = 0.0085). Conclusions The automatic smoke evacuation in flexible gastrointestinal endoscopy was potentially feasible and useful by improving the device setting.https://doi.org/10.1002/deo2.367endoscopic submucosal dissectionflexible endoscopyinfection controlsmoke evacuatorsurgical smoke
spellingShingle Yohei Nose
Motohiko Kato
Shoma Aoyagi
Kazunori Akeo
Kotaro Yamashita
Takuro Saito
Koji Tanaka
Kazuyoshi Yamamoto
Tomoki Makino
Tsuyoshi Takahashi
Yukinori Kurokawa
Hidetoshi Eguchi
Yuichiro Doki
Kiyokazu Nakajima
Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
DEN Open
endoscopic submucosal dissection
flexible endoscopy
infection control
smoke evacuator
surgical smoke
title Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
title_full Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
title_fullStr Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
title_full_unstemmed Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
title_short Use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy: Its feasibility and potential usefulness
title_sort use of current automatic smoke evacuation system in flexible gastrointestinal endoscopy its feasibility and potential usefulness
topic endoscopic submucosal dissection
flexible endoscopy
infection control
smoke evacuator
surgical smoke
url https://doi.org/10.1002/deo2.367
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