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. 2024 Nov 28;12(11):E1374-E1378.
doi: 10.1055/a-2422-2425. eCollection 2024 Nov.

Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video)

Yasuki Hori  1 , Kazuki Hayashi  2 , Itaru Naitoh  1 , Fumihiro Okumura  3 , Kaiki Anbe  4 , Katsuyuki Miyabe  5 , Atsuyuki Hirano  6 , Hiroki Takada  7 , Naruomi Jinno  8 , Michihiro Yoshida  1 , Akihisa Kato  1 , Kenta Kachi  1 , Hidenori Sahashi  1 , Akihisa Adachi  1 , Tadashi Toyohara  1 , Kayoko Kuno  1 , Yusuke Kito  1 , Hiromi Kataoka  1
Affiliations

Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video)

Yasuki Hori et al. Endosc Int Open. .

Erratum in

Abstract

Background and study aims 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. Methods 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. Results 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; P < 0.001). The newly designed r-sphincterotome rotated smoothly and consistently at a constant speed, mirroring the input rotation. Conclusions 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.

Keywords: ERC topics; Pancreatobiliary (ERCP/PTCD); Performance and complications; Quality and logistical aspects; Quality management; Training.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
An actual model of the experimental procedure show input and output degrees of the r-sphincterotomes evaluated in this study. The r-sphincterotome was inserted into a side-viewing duodenoscope, that was manipulated to mimic the curvature of the alimentary tract. The proximal end of the r-sphincterotome was attached to a servomotor, which rotated the sphincterotome at a constant speed (input; 1.5 revolution per minute), while the degree of rotation at the distal end was recorded over time (output; every 2 seconds).
Fig. 2
Fig. 2
The actual r-sphincterotomes and cutting wires of the r-sphincterotomes.
Fig. 3
Fig. 3
Components of the endoscopic rotatable sphincterotome and comparison of cutting wire configurations. The sphincterotome consists of an operating handle, a catheter, and a cutting wire. The cutting wire is tapered at its distal end to facilitate proper incision. The length of the tapered area and the proximal and distal diameters of the cutting wire are unique to each sphincterotome.
Fig. 4
Fig. 4
Schema illustrating the relationship between input and output degrees of the experimental procedure. The endoscopic rotatable sphincterotome was inserted into a side-viewing duodenoscope. The proximal end of the sphincterotome was fastened to a servomotor, which rotated the sphincterotome at a constant speed (input). The duodenoscope was held in a bent position to mimic the alimentary tract. The degree of rotation at the distal end over time was recorded (output).
See this image and copyright information in PMC

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