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Pulmonary Procedures |

New Bronchoscopy Procedures Enabled With Dual-Channel Flexible Bronchoscopes

Mitsuhiro Tada; Hibiki Kanda; Emiko Nishikawa; Shinichi Iwamoto; Toru Kadowaki; Kanako Kobayashi; Masahiro Kimura; Toshikazu Ikeda; Shuichi Yano
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National Hospital Organization Matsue Medical Center, Matsue-shi, Japan


Chest. 2015;148(4_MeetingAbstracts):807A. doi:10.1378/chest.2277460
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Abstract

SESSION TITLE: Interventional Pulmonology Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Development of flexible bronchoscopes with forceps and various instruments has led to advances in the field of bronchoscopy. However, flexible bronchoscopes have only one forceps channel, making insertion and simultaneous operation with multiple instruments difficult. We evaluated whether the conversion of a standard single-channel (SC) flexible bronchoscope into a dual-channel bronchoscope would enable simultaneous operation of multiple instruments thereby improving the speed and operation of endoscopic procedures.

METHODS: We initially used a commercially available external attachment that widened the forceps channel; this attachment is normally used with gastrointestinal endoscopes. We then used a flexible bronchoscope to enhance this attachment. We investigated various procedures using a bronchoscope simulation kit on a pig’s lung.

RESULTS: Although the attachment slightly impeded the bending operability of the flexible bronchoscope tip, the procedure was not affected. In procedures where forceps are used to achieve post-biopsy blood coagulation, simultaneous use of a biopsy forceps and an argon plasma coagulation (APC) probe as well as simultaneous use of a biopsy forceps and aspiration decreased the procedure time required for hemostasis versus that with use of a SC flexible bronchoscope. During procedures for foreign body removal from the trachea or for adjusting the position of the migrated silicone stent, simultaneous use of two grasping forceps enabled more stable and reliable procedures than the ones performed using a SC flexible bronchoscope.

CONCLUSIONS: The conversion of a standard SC flexible bronchoscope into a dual-channel bronchoscope yielded constant improvement in the speed and operability of endoscopy techniques. However, this technique has one limitation. The attachment increased the diameter of the endoscope tip; thus, limiting its use for procedures involving the central airway. In the future, the size of the attachment needs to be decreased. We will also report our experience regarding the use of this technique in clinical settings.

CLINICAL IMPLICATIONS: Simultaneous use of two instruments can further diversify bronchoscopy procedures.

DISCLOSURE: The following authors have nothing to disclose: Mitsuhiro Tada, Hibiki Kanda, Emiko Nishikawa, Shinichi Iwamoto, Toru Kadowaki, Kanako Kobayashi, Masahiro Kimura, Toshikazu Ikeda, Shuichi Yano

We wil discuss new bronchoscopy procedures enabled with dual-channel flexible bronchoscopes. We used a commercially available external attachment that widened the forceps channel; this attachment is normally used with gastrointestinal endoscopes. We then used a flexible bronchoscope to enhance this attachment. We investigated various procedures using a bronchoscope simulation kit on a pig’s lung.


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