Evidence map›Paper›PMID 28205029›Full record

ArticleSurgical endoscopy2017

Stray energy transfer during endoscopy.

Edward L Jones, Amin Madani, Douglas M Overbey, Asimina Kiourti, Satheesh Bojja-Venkatakrishnan, Dean J Mikami, Jeffrey W Hazey, Todd R Arcomano, Thomas N Robinson

Abstract read
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Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Edward L JonesDepartment of Surgery, The University of Colorado and The Denver VAMC, 1055 Clermont St, #112, Denver, CO, 80220, USA. edward.jones@UCDenver.edu.ORCID http://orcid.org/0000-0002-1449-8255
Amin MadaniDepartment of Surgery, McGill University, Montreal, Canada.
Douglas M OverbeyDepartment of Surgery, The University of Colorado and The Denver VAMC, 1055 Clermont St, #112, Denver, CO, 80220, USA.
Asimina KiourtiDepartment of Electrical and Computer Engineering, The Ohio State University, Columbus, OH, USA.
Satheesh Bojja-VenkatakrishnanDepartment of Electrical and Computer Engineering, The Ohio State University, Columbus, OH, USA.
Dean J MikamiDepartment of Surgery, The University of Hawaii, Honolulu, HI, USA.
Jeffrey W HazeyDepartment of Surgery, The Ohio State University, Columbus, OH, USA.
Todd R ArcomanoDepartment of Surgery, The University of Colorado and The Denver VAMC, 1055 Clermont St, #112, Denver, CO, 80220, USA.
Thomas N RobinsonDepartment of Surgery, The University of Colorado and The Denver VAMC, 1055 Clermont St, #112, Denver, CO, 80220, USA.

Funding

Society of American Gastrointestinal and Endoscopic Surgeons 2016
6 · The paper itself

Abstract

introductionEndoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. METHODS AND PROCEDURES: A gastroscope was introduced into the stomach of an anesthetized pig. A monopolar generator delivered energy for 5 s to a snare without contacting tissue or the endoscope itself. The endoscope tip orientation, energy device type, power level, energy mode, and generator type were varied to mimic in vivo use. The primary outcome (stray current) was quantified as the change in tissue temperature (°C) from baseline at the tissue closest to the tip of the endoscope. Data were reported as mean ± standard deviation.

resultsUsing the 60 W coag mode while changing the orientation of the endoscope tip, tissue temperature increased by 12.1 ± 3.5 °C nearest the camera lens (p < 0.001 vs. all others), 2.1 ± 0.8 °C nearest the light lens, and 1.7 ± 0.4 °C nearest the working channel. Measuring temperature at the camera lens, reducing power to 30 W (9.5 ± 0.8 °C) and 15 W (8.0 ± 0.8 °C) decreased stray energy transfer (p = 0.04 and p = 0.002, respectively) as did utilizing the low-voltage cut mode (6.6 ± 0.5 °C, p < 0.001). An impedance-monitoring generator significantly decreased the energy transfer compared to a standard generator (1.5 ± 3.5 °C vs. 9.5 ± 0.8 °C, p < 0.001).

conclusionStray energy is transferred within the endoscope during the activation of common energy devices. This could result in post-polypectomy syndrome, bleeding, or perforation outside of the endoscopist's view. Decreasing the power, utilizing low-voltage modes and/or an impedance-monitoring generator can decrease the risk of complication.

Indexed as

EndoscopesAnimalsBurns, ElectricCatheter AblationElectric ImpedanceEndoscopyEnergy TransferIntraoperative ComplicationsModels, AnimalSwineComplicationCouplingEndoscopyImpedancePolypectomyStray energy

Identifiers

PMID28205029

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.