Hori Yasuki, Hayashi Kazuki, Naitoh Itaru, Okumura Fumihiro, Anbe Kaiki, Miyabe Katsuyuki, Hirano Atsuyuki, Takada Hiroki, Jinno Naruomi, Yoshida Michihiro, Kato Akihisa, Kachi Kenta, Sahashi Hidenori, Adachi Akihisa, Toyohara Tadashi, Kuno Kayoko, Kito Yusuke, Kataoka Hiromi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan.
Department of Gastroenterology and Metabolism, Nagoya City University East Medical Center, Nagoya, Japan.
Endosc Int Open. 2024 Nov 28;12(11):E1374-E1378. doi: 10.1055/a-2422-2425. eCollection 2024 Nov.
Endoscopic sphincterotomy can be challenging especially in patients with surgically altered anatomy. Although a rotatable sphincterotome (r-sphincterotome) may be useful, its rotational function is often inadequate. We evaluated the feasibility of a newly designed r-sphincterotome equipped with a well-conceived cutting wire. We measured the movement and dynamics of both the newly designed r-sphincterotome and two existing r-sphincterotomes using in-house equipment. Ideally, the rotational force exerted at the proximal end should transmit directly to the distal end. But it is often challenging, particularly within the constraints of a bent endoscope and working channel. We collected data regarding deviation from the ideal value 10 times for each sphincterotome. The deviation from the ideal value was significantly lower with the newly designed r-sphincterotome than with the conventional r-sphincterotomes (44.9 ± 27.8 vs. 73.7 ± 44.6 and 130.1 ± 71.4 degrees, respectively; < 0.001). The newly designed r-sphincterotome rotated smoothly and consistently at a constant speed, mirroring the input rotation. We evaluated the feasibility of the newly designed r-sphincterotome using an experimental model. We believe that the findings from these experiments may contribute to easier and more precise sphincterotomies.
内镜下括约肌切开术可能具有挑战性，尤其是在解剖结构经过手术改变的患者中。尽管可旋转括约肌切开刀（r-括约肌切开刀）可能有用，但其旋转功能往往不足。我们评估了一种新设计的配备精心构思的切割丝的r-括约肌切开刀的可行性。我们使用内部设备测量了新设计的r-括约肌切开刀和两种现有的r-括约肌切开刀的运动和动力学。理想情况下，施加在近端的旋转力应直接传递到远端。但这通常具有挑战性，尤其是在内镜弯曲和工作通道的限制范围内。我们对每种括约肌切开刀偏离理想值的数据收集了10次。新设计的r-括约肌切开刀偏离理想值的程度明显低于传统的r-括约肌切开刀（分别为44.9±27.8度与73.7±44.6度和130.1±71.4度；P<0.001）。新设计的r-括约肌切开刀以恒定速度平稳且持续地旋转，与输入旋转一致。我们使用实验模型评估了新设计的r-括约肌切开刀的可行性。我们相信这些实验的结果可能有助于更轻松、更精确地进行括约肌切开术。
