The aim of this preliminary study was to determine the validity of a flexible fiberoptic
cable inserted into a nasogastric tube in assessing correct gastric placement of the
tube in children and adults. The study enrolled 16 patients undergoing surgical procedures
(β-thalassemic children and 8 patients subjected respectively to open splenectomy
and laparoscopic cholecystectomy). A flexible cable of 1.3 mm diameter, connected
with a cold light source, was inserted in a common nasogastric tube and advanced as
far as the epigastric area ([Fig. 1] - [3]), which was fully transilluminated. The stomach was emptied by aspiration with a
syringe. The size of the nasogastric tubes varied between 8 and 19 Fr (2.7 - 6.3 mm).
Fig. 1 Fiberoptic cable connected to a cold light source.
Fig. 2 The flexible fiberoptic cable.
Fig. 3 Transillumination of the upper abdominal wall.
All of the patients had the epigastric area transilluminated, and the liquid obtained
from the nasogastric tube aspiration was of clear yellow color. Moreover, correct
positioning of the nasogastric tube was confirmed at the time of operation in all
the patients, and no postinsertion complications were recorded.
Preoperative insertion of a flexible fiberoptic cable into a nasogastric tube may
be useful in allowing the operator to check that the device is progressing correctly
through the esophagus and correctly placed inside the stomach. This instrument also
allows preoperative stomach emptying. We believe that this finding deserves consideration
as it represents a useful, safe, and cost-effective tool for surgeons. This particular
device could also be useful in critically ill patients requiring gastric or enteral
feeding, in whom frequent checking of tube placement is needed. Further tests performed
on a greater number of patients are needed for a better evaluation of the importance,
possible applications, and manageability of this device.
Acknowledgment
This work has been partially funded by a grant from the Italian Ministry of University
and Research.
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