A novel lens cleaner to prevent water drop adhesions during colonoscopy and esophagogastroduodenoscopy

Abstract

Background and study aims Water drop adhesions (WDA) impair endoscopic view during gastrointestinal endoscopy. We developed a novel lens cleaner designed using two types of harmLess surfactants and it is reported to be useful for preventing lens cloudiness during colorectal ESD. In the current study, we examined the ability of it for preventing and removing WDA.

Patients and methods During laboratory experiments, the cleaner (Cleash; Fujifilm Co., Tokyo, Japan and Nagase Medicals Co., Hyogo, Japan) was applied to the endoscopic lens and an air/water device (AWD) (water 200 mL, dimethicone 1 mL, Cleash 1 mL). The endoscope was submerged in water 100 times for 5 cycles. Rates of WDA were calculated for various groups (lens and AWD with or without Cleash) and compared to a normal cleaner (SL cleaner). During clinical research, 30 colonoscopies and 30 esophagogastroduodenoscopies were analyzed. For the Cleash group, the cleaner was applied to both lens and AWD. The numbers of WDA and WDA with non-rapid removal were calculated, compared to those of the SL cleaner group.

Results The mean WDA rate for the Cleash setting (lens: Cleash; AWD: Cleash) was 11.0 %, which was significantly lower than other settings (lens: SL cleaner; AWD: water, 31.0 %; P < 0.001) (lens: Cleash; AWD: water, 19.0 %; P < 0.001). Clinical research of colonoscopies indicated that the numbers of WDA (number/15 sec) and WDA with non-rapid removal were 0.38 and 0.17 for the Cleash group and 0.91 and 0.46 for the SL cleaner groups (P < 0.001, P < 0.001). For esophagogastroduodenoscopies, the results were 0.47 and 0.24 for the Cleash group and 0.54 and 0.42 for the SL cleaner group (P = 0.72, P = 0.018).

Conclusion A clear and beautiful image without WDA is useful not only for routine endoscopy but also, more importantly, for magnifying endoscopy and other endoscopic treatments. The use of Cleash to lens and AWD showed positive results for preventing and removing WDA during laboratory experiments and clinical research involving CS. Additionally, it also showed positive results for the removal of WDA during EGD.

• References

• 1 Kobayashi E, Kakuda M, Tanaka Y. et al. A novel device for cleaning the camera port during laparoscopic surgery. Surg Endosc 2016; 30: 330-334
• 2 Yoshida N, Hisabe T, Inada Y. et al. The ability of a novel blue laser imaging system for the diagnosis of invasion depth of colorectal neoplasms. J Gastroenterol 2014; 49: 73-80
• 3 Kudo S, Hirota S, Nakajima T. et al. Colorectal tumours and pit pattern. J Clin Pathol 1994; 47: 880-885
• 4 Yoshida N, Hisabe T, Hirose R. et al. Improvement in the visibility of colorectal polyps by using blue laser imaging. Gastrointest Endosc 2015; 82: 542-549
• 5 Saito Y, Uraoka T, Yamaguchi Y. et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 2010; 72: 1217-1225
• 6 Sano Y, Tanaka S, Kudo SE. et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc 2016; 28: 526-533
• 7 Yoshida N, Naito Y, Hirose R. et al. Risk of lens cloudiness during colorectal endoscopic submucosal dissection & ability of a novel lens cleaner to maintain and restore endoscopic view. Dig Endosc 2015; 27: 609-617
• 8 Komazawa Y, Amano Y, Yuki M. et al. Oolong tea is useful for lens cleansing in transnasal small-caliber esophagogastroduodenoscopy. Endoscopy 2010; 42: 104-108
• 9 Song S, Zhu L, Zhou W. Simultaneous removal of phenanthrene and cadmium from contaminated soils by saponin, a planet-derived biosurfactant. Environ Pollut 2008; 156: 1368-1370
• 10 Van Deurzen DF, Mannaerts GH, Jakimowicz JJ. et al. Prevention of lens condensation in laparoscopic surgery by lens heating with a thermos flask. Surg Endosc 2005; 19: 299-300
• 11 Brown JA, Inocencio MD, Sundaram CP. Use of warming bath to prevent lens fogging during laparoscopy. J Endourol 2008; 22: 213-214