Differences in fluid removal of different open-pore elements for endoscopic negative pressure therapy in the upper gastrointestinal tract

Abstract

Endoscopic negative pressure therapy is an effective treatment strategy for various defects of the gastrointestinal tract. The functional principle is based on an open-pore element, which is placed around a perforated drainage tube and connected to a vacuum source. The resulting open-pore suction device can undergo endoluminal or intracavitary placement. Different open-pore suction devices are used for endoscopic negative pressure therapy of upper gastrointestinal tract defects. Comparative analyses for features and properties of these devices are still lacking. Eight different (six hand-made devices and two commercial devices) open-pore suction devices for endoscopic negative pressure therapy of the upper gastrointestinal tract were used, amount fluid removed was evaluated. The evaluation parameters included the time to reach the target pressure, the time required to remove 100 ml of water, and the material resistance of the device. All open-pore suction devices are able to aspirate the target volume of fluids. The time to reach the target volume varied considerably. Target negative pressure was not achieved with all open-pore suction devices during the aspiration of fluids; however, there was no negative effect on suction efficiency. Of the measurement data, material resistance could be calculated for six open-pore elements. We present a simple experimental, nonphysiologically setup for open-pore suction devices used for endoscopic negative pressure therapy. The expected quantity of fluids secreted into the treated organs should affect open-pore suction device for endoscopic negative pressure therapy.

Figure 1

Experimental setup. (A) Water container, (B) Electric vacuum pump with water canister, OPSD: Open-pore suction device (for tested OPSD see Fig. 2).

Figure 2

Tested open-pore suction devices for ENPT of the UGIT. (a) Self-made gastric tube with CNP-film wrapped around the distal perforations. (b) Self-made PU sponge drainage on a 16Ch nasogastric tube. (c) Enteral feeding tube with two lumen and wrapped CNP-film around the gastric tube. (d) Enteral feeding tube with three lumen and wrapped CNP-film around the gastric tube. (e) Self-made feeding tube, using a 16Ch nasojejunal tube (length 125 cm) with an introduced 9Ch intestinal tube and CNP-film around the gastric tube. (f) Self-made combination of two OPSD. The distal end of a nasogastric tube (16Ch) is wrapped with a PU sponge. Over the sponge the CNP-film is single-layered placed. (g) The commercially available Eso-Sponge system a PU sponge with a fixed 9Ch drainage tube. (h) The new commercially available combination product VAC-Stent with integrated 9Ch drainage tube. ENPT: endoscopic negative pressure therapy; OPSD: open-pore suction device; PU: polyurethane; UGIT: upper gastrointestinal tract.