Development of gastric residue suction method using ultrathin endoscope assisted-balloon overtube: in vivo experience

Aims: Gastric residues involving blood clots and food interrupt the endoscopic intervention, leading to poor outcomes of endoscopic hemostasis. However, devices that enable to remove effectively gastrointestinal residues remain still unsatisfactory. This study aimed to evaluate the safety and efficacy of our developed suction method.
Methods: This was an experimental study on five beagle dogs in which food jelly was filled as the virtual gastric residue. The equipments consisted of a balloon overtube (FUJIFILM) and an ultrathin endoscope for the navigation-use. First, a cross incision was made at the base of the overtube, and the endoscope was fixed at the distal tip of the overtube through the incision hole. Suction was performed twice for five dogs, amounting for a total of 10 attempts. Continuous suction was possible by pressing the biopsy forceps on the superficial mucosa. The measure outcome was the successful procedure rate, defined as visual recognition of the folds after suctioning of the residue. Secondary outcomes were procedure-associated complications and procedure time.
Results: The successful procedure was achieved in all 10 attempts. No complications occurred. The mean procedure time was 5 min.
Conclusion: This experiment demonstrated that this novel method may be efficient for removing gastric residue, probably leading to the development of the instrument.