Novel rigidizing overtube for colonoscope stabilization and loop prevention (with video)

Area of Science:

• Gastroenterology
• Medical Devices
• Endoscopy

Background:

• Endoscopic loop formation impedes instrument advancement, causes instability, and patient discomfort.
• Existing methods like torque maneuvers and variable stiffness shafts are not always sufficient.
• Novel instruments are needed to manage challenging loop formation during endoscopic procedures.

Purpose of the Study:

• To evaluate the utility of a novel rigidizing overtube in managing loop formation during colonoscopy and other endoscopic procedures.
• To assess the safety and efficacy of the Pathfinder overtube in complex cases.

Main Methods:

• A case series involving 29 patients undergoing various endoscopic procedures.
• Utilized an 85 cm long, flexible overtube that rigidizes upon vacuum application, becoming 15 times stiffer.
• The overtube accommodates a pediatric colonoscope, allowing for controlled endoscope advancement.

Main Results:

• The overtube was used in 29 patients, primarily for colonoscopy (82.8%) and enteroscopy (13.8%).
• Indications included incomplete colonoscopy (41.4%), achieving depth (20.7%), and enhancing stability (37.9%).
• No adverse events were reported during the procedures.

Conclusions:

• The novel rigidizing overtube demonstrates utility in colonoscopy and other endoscopic procedures where loop management is critical.
• This tool offers a promising solution for overcoming challenges associated with endoscope looping.
• Initial experience suggests the Pathfinder overtube can improve procedural success and patient comfort.