Document Detail


Device choice and experience level in endoscopic foreign object retrieval: an in vivo study.
MedLine Citation:
PMID:  9199906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Successful foreign object retrieval may depend on device choice and the experience level of the endoscopist, although these factors have not been systematically evaluated. METHODS: In anesthetized pigs, the ability to retrieve foreign objects (metal tack, button disc battery, wooden toothpick) placed endoscopically into the stomach was assessed. Seven university medical center gastroenterology attending physicians (5 clinical and 2 basic science research [BSR]), and 4 fellows-in-training participated. The devices used were the Roth retrieval net, rat tooth forceps, Dormia basket, polypectomy snare, and radial jaw forceps. The time to retrieve each object into an esophageal overtube within a 5 minute maximum was measured. RESULTS: Only the Roth net and Dormia basket were successful in retrieving the button disc battery, although the Roth net was superior (100% vs 27%, Fisher p < 0.025). All devices were equally successful at retrieving the tack (82% to 100%, p = NS). The snare was significantly faster than the Roth net (p < 0.05). For the tack, there was significantly fewer difficulties encountered with the snare than the Roth net (Fisher p < 0.03). The Roth net was incapable of retrieving the toothpick; the other devices were equally successful (91% to 100%). The clinical attendings had a significantly higher success rate (95%) than the fellows (82%, chi squared p < 0.05) or combined fellows/BSR attendings (80%, p < 0.02), and were significantly faster than the fellows (p < 0.0002) or the fellows/BSR attendings (p < 0.0003). CONCLUSIONS: The Roth net is the best device for retrieving smooth objects such as the button disc battery. For sharp objects, such as the tack and toothpick, best results were achieved with the snare, although the forceps were also effective. More experienced endoscopists had higher success rates and faster retrieval times. Both device choice and the experience level of the endoscopists have an impact on successful foreign object retrieval.
Authors:
D O Faigel; B R Stotland; M L Kochman; T Hoops; T Judge; J Kroser; J Lewis; W B Long; D C Metz; C O'Brien; D B Smith; G G Ginsberg
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  45     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-13     Completed Date:  1997-08-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  490-2     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Pennsylvania Health System, Philadelphia 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Foreign Bodies / therapy*
Gastroscopes*
Gastroscopy / methods
Male
Physician's Practice Patterns*
Stomach*
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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