Exerting Forces and Wall Load during Duodenoscopy for ERCP: An Experimental Measurement in an Artificial Model.
ERCP
iatrogenic duodenal perforation
wall stress during endoscopy
Journal
Bioengineering (Basel, Switzerland)
ISSN: 2306-5354
Titre abrégé: Bioengineering (Basel)
Pays: Switzerland
ID NLM: 101676056
Informations de publication
Date de publication:
26 Apr 2023
26 Apr 2023
Historique:
received:
23
03
2023
revised:
22
04
2023
accepted:
24
04
2023
medline:
27
5
2023
pubmed:
27
5
2023
entrez:
27
5
2023
Statut:
epublish
Résumé
Endoscopic retrograde cholangiopancreatography (ERCP) is crucial to the treatment of biliopancreatic diseases with iatrogenic perforation as a potential complication. As of yet, the wall load during ERCP is unknown, as it is not directly measurable during an ERCP in patients. In a life-like, animal-free model, a sensor system consisting of five load cells was attached to the artificial intestines (sensors 1 + 2: pyloric canal-pyloric antrum, sensor 3: duodenal bulb, sensor 4: descending part of the duodenum, sensor 5: distal to the papilla). Measurements were made with five duodenoscopes (n = 4 reusable and n = 1 single use). Fifteen standardized duodenoscopies were performed. Peak stresses were found at the antrum during the gastrointestinal transit (sensor 1 max. 8.95 N, sensor 2 max. 2.79 N). The load reduced from the proximal to the distal duodenum and the greatest load in the duodenum was discovered at the level of the papilla in 80.0% (sensor 3 max. 2.06 N). For the first time, intraprocedural load measurements and exerting forces obtained during a duodenoscopy for ERCP in an artificial model were recorded. None of the tested duodenoscopes were classified as dangerous for patient safety.
Sections du résumé
BACKGROUND
BACKGROUND
Endoscopic retrograde cholangiopancreatography (ERCP) is crucial to the treatment of biliopancreatic diseases with iatrogenic perforation as a potential complication. As of yet, the wall load during ERCP is unknown, as it is not directly measurable during an ERCP in patients.
METHODS
METHODS
In a life-like, animal-free model, a sensor system consisting of five load cells was attached to the artificial intestines (sensors 1 + 2: pyloric canal-pyloric antrum, sensor 3: duodenal bulb, sensor 4: descending part of the duodenum, sensor 5: distal to the papilla). Measurements were made with five duodenoscopes (n = 4 reusable and n = 1 single use).
RESULTS
RESULTS
Fifteen standardized duodenoscopies were performed. Peak stresses were found at the antrum during the gastrointestinal transit (sensor 1 max. 8.95 N, sensor 2 max. 2.79 N). The load reduced from the proximal to the distal duodenum and the greatest load in the duodenum was discovered at the level of the papilla in 80.0% (sensor 3 max. 2.06 N).
CONCLUSIONS
CONCLUSIONS
For the first time, intraprocedural load measurements and exerting forces obtained during a duodenoscopy for ERCP in an artificial model were recorded. None of the tested duodenoscopes were classified as dangerous for patient safety.
Identifiants
pubmed: 37237593
pii: bioengineering10050523
doi: 10.3390/bioengineering10050523
pmc: PMC10215224
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Int J Med Robot. 2005 Dec;1(4):89-97
pubmed: 17518409
Ulus Travma Acil Cerrahi Derg. 2016 Sep;22(5):441-448
pubmed: 27849320
Endosc Int Open. 2019 Nov;7(11):E1424-E1431
pubmed: 31673614
Gastrointest Endosc. 2016 May;83(5):934-43
pubmed: 26439541
BMC Gastroenterol. 2022 Aug 14;22(1):385
pubmed: 35965340
Ann Surg. 2000 Aug;232(2):191-8
pubmed: 10903596
Surg Endosc. 2020 Jan;34(1):77-87
pubmed: 30859489
Surg Laparosc Endosc Percutan Tech. 2013 Dec;23(6):e225-8
pubmed: 24300937
Surg Endosc. 2020 May;34(5):1939-1947
pubmed: 31559577
Minerva Gastroenterol (Torino). 2021 Sep;67(3):276-282
pubmed: 32492997
Dig Liver Dis. 2018 May;50(5):514
pubmed: 29291918
DEN Open. 2021 Aug 22;2(1):e48
pubmed: 35310693
Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):19-29
pubmed: 33786113
Endoscopy. 2002 Apr;34(4):293-8
pubmed: 11932784
Surg Endosc. 2018 Dec;32(12):4841-4849
pubmed: 29770887
Endoscopy. 2015 0;47(S 01):E577-E578
pubmed: 26649468
J Mech Behav Biomed Mater. 2019 Mar;91:139-148
pubmed: 30579111
Ann Gastroenterol. 2014;27(1):65-72
pubmed: 24714755