Department of Next Generation Endoscopic Intervention (Project ENGINE), Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suite 0912, 2‑2, Yamadaoka, Suita, Osaka, 565‑0871, Japan.
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Surg Endosc. 2023 Mar;37(3):1718-1726. doi: 10.1007/s00464-022-09668-y. Epub 2022 Oct 7.
With the global epidemic of SARS-CoV-2, there has been a growing concern regarding the risk of aerosol exposure to healthcare workers and patients during medical/surgical interventions. The Schlieren device is capable of visualizing fine gas-flows by using refractive index differences in the medium. We aimed to reveal the existence of gas leakage from gastro-intestinal endoscopy system by utilizing Schlieren device and to clarify the factors which relates to the amount of gas leakage.
The experiments were performed on the excised swine stomach while maintaining a constant pressure environment in the stomach. The System Schlieren (SS100,KatoKoken) was used to visualize possible gas leakages from forceps plugs of endoscopy. We attempted to semi-quantify the leakage by referring to the image of the gas from the forceps plug and by measuring the initial velocity and diffusion area of the leakage.
Regardless of the type of forceps plugs, a certain amount of leakage was detected during both insertion and removal of forceps. The initial velocity and the diffusion area of the leakage increased with the increase in intragastric pressure. Semi-quantitative comparison showed that there was a difference in the amount of gas leakage among various forceps plugs. Furthermore, the amount of gas leakage was significantly greater in the forceps plugs that were used repeatedly.
It was possible to visualize gas leakages from the gastrointestinal endoscope system using the Schlieren optical device. Avoiding too high intragastric pressure and not using deteriorated plugs may reduce the risk of aerosol exposure.
随着 SARS-CoV-2 的全球流行，人们越来越关注医疗/手术干预期间医护人员和患者暴露于气溶胶的风险。纹影设备能够通过介质中的折射率差异来可视化细微气流。我们旨在利用纹影设备揭示胃肠内窥镜系统存在气体泄漏，并阐明与气体泄漏量相关的因素。
在胃内保持恒定压力环境的情况下，对切除的猪胃进行实验。使用 Schlieren 系统（SS100，KatoKoken）来可视化内窥镜器械夹钳处可能存在的气体泄漏。我们试图通过参考器械夹钳处的气体图像以及测量泄漏的初始速度和扩散面积来对泄漏进行半定量评估。
无论器械夹钳的类型如何，在插入和取出器械时都会检测到一定量的泄漏。泄漏的初始速度和扩散面积随着胃内压力的增加而增加。半定量比较显示，不同器械夹钳的气体泄漏量存在差异。此外，重复使用的器械夹钳的气体泄漏量明显更大。
使用纹影光学设备可以可视化胃肠内窥镜系统的气体泄漏。避免过高的胃内压力和不使用恶化的器械夹钳可能会降低气溶胶暴露的风险。
