一种用于测量胃肠道慢波活动的新型腹腔镜设备。
A novel laparoscopic device for measuring gastrointestinal slow-wave activity.
机构信息
Department of Surgery, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
出版信息
Surg Endosc. 2009 Dec;23(12):2842-8. doi: 10.1007/s00464-009-0515-2. Epub 2009 May 23.
BACKGROUND
A periodic electrical activity, termed "slow waves", coordinates gastrointestinal contractions. Slow-wave dysrhythmias are thought to contribute to dysmotility syndromes such as postoperative gastroparesis, but the clinical significance of these dysrhythmias remains poorly defined. Electrogastrography (EGG) has been unable to characterize dsyrhythmic activity reliably, and the most accurate method for evaluating slow waves is to record directly from the surface of the target organ. This study presents a novel laparoscopic device for recording serosal slow-wave activity, together with its validation.
METHODS
The novel device consists of a shaft (diameter, 4 mm; length, 300 mm) and a flexible connecting cable. It contains four individual electrodes and is fully shielded. Validation was performed by comparing slow-wave recordings from the laparoscopic device with those from a standard electrode platform in an open-abdomen porcine model. An intraoperative human trial of the device also was performed by recording activity from the gastric antrum of a patient undergoing a laparoscopic cholecystectomy.
RESULTS
Slow-wave amplitudes were similar between the laparoscopic device and the standard recording platform (mean 0.38 ± 0.03 mV vs range 0.36-0.38 ± 0.03 mV) (p = 0.94). The signal-to-noise ratio (SNR) also was similar between the two types of electrodes (13.7 dB vs 12.6 dB). High-quality antral slow-wave recordings were achieved in the intraoperative human trial (amplitude, 0.41 ± 0.04 mV; SNR, 12.6 dB), and an activation map was constructed showing normal aboral slow-wave propagation at a velocity of 6.3 ± 0.9 mm/s.
CONCLUSIONS
The novel laparoscopic device achieves high-quality serosal slow-wave recordings. It is easily deployable and atraumatic. It is anticipated that this device will aid in the clinical investigation of normal and dsyrhythmic slow-wave activity. In particular, it offers new potential for investigating the effect of surgical procedures on slow-wave activity.
背景
周期性电活动，称为“慢波”，协调胃肠收缩。慢波节律紊乱被认为与运动障碍综合征有关，如术后胃轻瘫，但这些节律紊乱的临床意义仍未明确定义。胃电图（EGG）一直无法可靠地描述心律失常活动，评估慢波的最准确方法是直接记录目标器官的表面。本研究提出了一种新型的腹腔镜设备来记录浆膜慢波活动，并对其进行了验证。
方法
新型设备由轴（直径 4mm，长 300mm）和柔性连接电缆组成。它包含四个独立的电极，完全屏蔽。通过在开腹猪模型中比较腹腔镜设备和标准电极平台的慢波记录来验证。还对一名接受腹腔镜胆囊切除术的患者的胃窦进行了设备的术中人体试验。
结果
慢波幅度在腹腔镜设备和标准记录平台之间相似（平均 0.38±0.03mV 与范围 0.36-0.38±0.03mV）（p=0.94）。两种电极的信噪比（SNR）也相似（13.7dB 与 12.6dB）。术中人体试验中获得了高质量的胃窦慢波记录（幅度 0.41±0.04mV；SNR 12.6dB），并构建了激活图，显示了正常的逆行慢波传播，速度为 6.3±0.9mm/s。
结论
新型腹腔镜设备可实现高质量的浆膜慢波记录。它易于部署且无创伤。预计该设备将有助于正常和心律失常慢波活动的临床研究。特别是，它为研究手术程序对慢波活动的影响提供了新的潜力。
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