Hawari Rami, Pasricha Pankaj Jay
Division of Gastroenterology and Hepatology, University of Texas Medical Branch 4.106 McCullough Building, 301 University Boulevard, Galveston, TX 77555-0764, USA.
J Clin Gastroenterol. 2007 Feb;41(2):138-40. doi: 10.1097/01.mcg.0000225595.01201.d2.
In up to 10% to 20% of colonoscopies, complete intubation of the colon may be considerably difficult. A principal cause of difficulty is looping of the endoscope shaft in a floppy, often tortuous segment of the colon that typically happens in the sigmoid colon. Also, if looping is not recognized and the scope is advanced with abandon, the risk of perforation will rise. Special "variable stiffness" colonoscopies are expensive and have not been unequivocally shown to be useful in preventing looping. The simplest approach to prevent looping is perhaps the use of an over-tube to prevent the shaft from bowing out. The ShapeLock could offer an ideal over-tube that is flexible enough to safely and easily negotiate bends in the colon but when needed be rigid enough to prevent looping with just a snap of its handle. It also has potential other applications including enteroscopy, transgastric endoscopy and access to difficult regions of the upper gastrointestinal tract.
在高达10%至20%的结肠镜检查中，对结肠进行完全插管可能相当困难。造成困难的一个主要原因是内镜镜身（在结肠的一个松弛、通常呈迂曲状的节段，典型情况发生在乙状结肠）形成袢曲。此外，如果未识别出袢曲且盲目推进内镜，穿孔风险将会增加。特殊的“可变硬度”结肠镜价格昂贵，而且尚未明确显示在预防袢曲方面有用。预防袢曲的最简单方法可能是使用外套管以防止镜身向外弯曲。ShapeLock可能提供一种理想的外套管，它足够灵活，能够安全、轻松地通过结肠中的弯曲部位，但在需要时又足够坚硬，只需轻按手柄就能防止形成袢曲。它还可能有其他应用，包括小肠镜检查、经胃内镜检查以及进入上消化道的困难区域。
