Pini Prato A, Martucciello G, Jasonni V
Department and Chair of Pediatric Surgery, Giannina Gaslini Institute, University of Genova, Italy.
J Pediatr Surg. 2001 Sep;36(9):1364-6. doi: 10.1053/jpsu.2001.26370.
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.
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.
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.
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.
背景/目的：直肠黏膜-黏膜下层标本的术前组织化学检查是先天性巨结肠及其他神经节发育异常疾病诊断中最重要的步骤。如今，直肠黏膜-黏膜下层活检标本是通过使用20世纪60年代末诺布利特首次设计的广泛应用的工具进行抽吸获取的。作者开发了一种新器械，已申请专利，可单手进行直肠抽吸活检，这将使该操作更简便、快捷。
作者对旧工具进行了改进，但保留了诺布利特描述的切割方法。作者创新的自动工具（Solo-RBT）基于仅通过按下“扳机”就能对直肠黏膜进行抽吸和切割排序的可能性。扳机启动一个柱塞以获得抽吸所需的真空，并启动一个切割器进行黏膜采样。为了对不同体重的儿童和成人进行正确的活检，Solo-RBT可以进行适当调整，以自动获得每种情况下所需的真空。此外，该工具配备了两种不同尺寸的胶囊和切割器，并且可以完全拆卸，便于清洁、维护和消毒。
该器械在62名儿童身上进行了临床测试（189次活检），结果证明它用途广泛、无创伤且极其方便，因为仅需一名医生操作，只需按下扳机就能获取活检标本。
Solo-RBT不仅保留了诺布利特工具的优点（无创伤、易于使用、快速）和主要特征（切割系统），还改进了其特性并消除了大部分缺点。因此，Solo-RBT代表了先天性巨结肠及其他神经节发育异常疾病诊断方面的重大进步。
