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A novel endoscopic device for repeated right-side colonic access during colonoscopy (with video)

  • Author Footnotes
    ⁎ These authors contributed equally to the concept, design, and writing of this article and share first authorship.
    Arnulf Ferlitsch
    Footnotes
    ⁎ These authors contributed equally to the concept, design, and writing of this article and share first authorship.
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Gerd R. Silberhumer
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Wayne Noda
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Tudor Birsan
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Devendra Desai
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Ajay Kumar
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Guduru V. Rao
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Aditya Khakar
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Nestor A. Gomez
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Christoph Gasche
    Correspondence
    Reprint requests: Prof. Christoph Gasche, Dept. of Medicine 3, Division of Gastroenterology and Hepatology, Medical University of Vienna
    Affiliations
    Current affiliations: Departments of Medicine 3 (A.F., C.G.), General Surgery (G.S., T.B.), Medical University of Vienna, Vienna, Austria; Minos Medical, Irvine, California (W.N., C.G.); Hinduja Hospital, Mumbai, India (D.D.); Indraprastha Apollo Hospital, New Delhi, India (A.J.); Asian Institute of Gastroenterology, Hyderabad, India (G.R.); Janaki Centre, Kohapur, India (A.K.); Kennedy Hospital, Guayaquil, Ecuador (N.G.)
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  • Author Footnotes
    ⁎ These authors contributed equally to the concept, design, and writing of this article and share first authorship.

      Background

      Megachannel is a newly developed colonic access system allowing rapid and multiple passes of the colonoscope to the right side of the colon.

      Objective

      The aim of this study was to evaluate the safety and clinical feasibility of placing a 100 cm Megachannel prototype in the right side of the colon.

      Setting

      Six centers, international, both surgeons and gastroenterologists performing endoscopy.

      Design and Intervention

      Patients scheduled for colonoscopy with suspected right-side colonic polypoid lesions were included. The prototype was loaded onto a 160 cm lower GI endoscope and introduced via colonoscopic guidance.

      Main Outcome Measurement

      The ability to place this device in the right side of the colon.

      Results

      The Megachannel prototype was introduced in 41 patients (19 female, mean age 54 years) undergoing colonoscopy. The cecum was reached in 27 cases (66%) within 18 minutes (range, 3-35 minutes) and with 73 cm (range, 40-100 cm) of the device being inserted into the colon. Mild tissue bruises and mild pain were observed in 5 and 3 patients, respectively. In 14 patients, the device assisted the removal of multiple polyps (2-12) as tissue was repeatedly retrieved through the channel. The device also allowed delivery of an endoscopic US scope or suction caps to the right side of the colon.

      Limitations

      Prototype performance may differ from the actual product (80 cm in length, redesigned introducer plugs). Small number of patients, difficult in diverticular disease.

      Conclusions

      This newly developed colonic access system can be safely placed in the right side of the colon and is useful for a variety of advanced procedures that require repeated insertion of the colonoscope or delivery of bulky instruments. (Clinical trial registration number: NCT00987896.)
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