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首页> 外文期刊>Surgical Endoscopy >Novel device to detect enterotomies in real time during laparoscopy: first in human trial during Roux-en-y gastric bypass
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Novel device to detect enterotomies in real time during laparoscopy: first in human trial during Roux-en-y gastric bypass

机译：新型设备在腹腔镜检查期间实时检测肠胃弥孔：在Roux-Zh-Y胃旁路期间的人类试验中

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Background Undetected bowel perforations occur in 0.3-1% of laparoscopic surgical procedures with an associated mortality rate of 5.3%. Objective The purpose of the study was to evaluate the clinical feasibility of a novel medical device to accurately detect bowel gas, specifically hydrogen (H_2) and methane (CH_4), from a sample of gas from the abdominal cavity during laparoscopic surgery when a known bowel wall perforation has occurred. Setting: University (Academic) Hospital. Methods A prospective single arm study was composed of 8 patients undergoing a standard laparoscopic roux-en-y gastric bypass. At seven time points during the operation intra-abdominal gas was pulled from the abdominal cavity and analyzed using the novel device for H_2 and CH_4. The time points included after insufflation (T1), after first jejunotomy (T2), after closure of jejunotomy (T3), after recycle of carbon dioxide gas (T4), after gastrostomy (T5), after jejunotomy (T6), at procedure end (T7). Results Eight patients were enrolled in the study; in 7 (87.5%) patients data from all 7 time points were obtained. After the first opening of the small bowel (T2) mean hydrogen levels were significantly increased compared to baseline hydrogen levels (T1, T4, T7) (p < 0.001). At all time points, there was no significant detection of methane. There were no intra-operative or post-operative complications during the study. Conclusion Hydrogen gas is released into the intra-abdominal cavity when bowel is opened and can be detected in real time using a novel device during laparoscopic surgery. The presence or absence of hydrogen directly correlates to whether the bowel is open (perforated) or intact. This device could be used in the future to detect unintended bowel perforations during laparoscopic surgery, prior to the conclusion of the operation. This technology could also potentially lead to novel mechanism for detecting postoperative leaks using gas detection technology.
机译：背景技术未检测到的肠穿孔发生在0.3-1％的腹腔镜手术手术中，其死亡率为5.3％。目的本研究的目的是评估新型医疗装置的临床可行性，以准确地检测腹腔镜在腹腔腔内的气体样品中精确地检测肠道气体，特别是氢气（H_2）和甲烷（CH_4），当已知的排便时墙壁穿孔发生了。环境：大学（学术）医院。方法采用预期腹腔镜Roux-Zh-Y胃旁路的8名患者组成了前瞻性单臂研究。在七次时间点，在操作期间，腹腔内气体从腹腔拉出并使用新型装置进行分析，用于H_2和CH_4。在吹入后（t1）之后包括的时间点（t1），在第一Jejunotomy（t2）之后，在闭合JejunoTomy（t3）之后，在胃术（T5）回收二氧化碳气体（t5）之后，在Jejunotomy（t6）之后，在进行过程结束后（t7）。结果八名患者注册了该研究;在7（87.5％）所有7个时间点的患者中。与基线氢水平相比，在小肠（T2）平均氢水平的第一次开启（T2）平均值之后（T1，T4，T7）（P <0.001）。在所有时间点，没有明显的甲烷检测。在研究期间没有手术内或术后并发症。结论在腹腔镜手术期间使用新型装置在腹腔内释放到腹腔内腔内氢气进入腹腔内腔内。氢的存在或不存在直接相关与肠道是否打开（穿孔）或完整。在经营结束之前，将来可以在将来使用未来在腹腔镜手术期间检测意外的肠穿孔。该技术还可能导致使用气体检测技术检测术后泄漏的新机制。

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