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Assessment of a modified technique for air delivery during fluoroscopic-monitored pneumatic intussusception reduction
Gaurav Jindal1,2, Brendon L Graeber1, Lawrence H Staib1
1Department of Radiology & Biomedical Imaging, Yale School of Medicine, 333 Cedar St., P.O. Box 208042, New Haven, CT, 06520, USA.
Insights
A modified technique for pneumatic intussusception reduction in children offers improved operator comfort without compromising procedure effectiveness or patient outcomes. This method uses a standard medical air supply for more consistent pressure delivery during fluoroscopic-monitored reductions.
Area of Science:
- Pediatric Surgery
- Medical Device Engineering
Background:
- Intussusception is a frequent pediatric surgical emergency.
- Image-monitored pressure reduction is the primary treatment approach.
Purpose of the Study:
- To introduce and evaluate a modified air delivery system for fluoroscopic-monitored pneumatic intussusception reduction.
- To compare the modified technique with the established method.
Main Methods:
- Modification of the Shiels intussusception reduction device to utilize hospital medical air supply.
- Retrospective comparison of standard and modified techniques in pediatric patients (<18 years).
- Evaluation of procedure parameters (time, fluoroscopy, radiation) and patient outcomes (reduction success, recurrence, surgery rates).
Main Results:
- No statistically significant differences were observed between the standard and modified techniques.
- Procedure parameters and patient outcomes remained comparable between both methods.
Conclusions:
- The modified device enhances operator comfort during pneumatic intussusception reduction.
- The technique is a safe and effective alternative to the standard method, maintaining similar clinical results.
Background:
Intussusception is one of the most common causes of acute abdominal emergency in children. Image-monitored pressure reduction is the first line of treatment.
Objective:
We report on a modified technique of air delivery during fluoroscopic-monitored pneumatic intussusception reductions, and compare it with an established technique.
Materials And Methods:
We modified the Shiels intussusception reduction device so that the air used for intussusception reduction is delivered not by the device's insufflator bulb, but rather by the hospital medical air supply system, eliminating the need for continuous pumping of the insufflator bulb during the procedure. Subsequently, we retrospectively compared sequential fluoroscopy-monitored pneumatic intussusception reduction procedures performed in patients younger than 18 years using either the standard or modified devices, evaluating technical procedure parameters (i.e. median procedure time length, fluoroscopy time length and radiation dose) and patient outcomes (i.e. number of complete intussusception reductions, number of incomplete intussusception reductions, number of intussusception recurrences within 3 days of the procedure, number of procedures followed by surgery).
Results:
We found no statistically significant differences between procedures performed with the standard and modified techniques.
Conclusion:
The device modification allows for increased operator comfort. Evaluated procedure parameters and patient outcomes appear similar to those of the standard technique.
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