In NOTES, it is mandatory to maintain a high bacterial clearance level in the gastrointestinal tract, the route of access to intraperitoneal cavity. In NOTES that is conducted through the lower gastrointestinal tract that is convenient among routes of access to intraperitoneal cavity, it is very difficult to obtain a bacterial clearance level at which no peritonitis occurs. We invented and hereby report a high-speed cleaning unit that efficaciously cleans the gastrointestinal tract, as well as an evaluation method that uses a confocal laser observation device that can instantaneously evaluate the bacterial clearance level in the gastrointestinal tract after clearance and a digital imaging analyzer.
High-speed cleaning unit: It consists of 1) a cleaning pump that has a high-speed rotating fin which cleans the balloon for sealing to ensure bacterial clearance level in the disinfected and cleaned gastrointestinal tract and its anal end, as well as of 2) a short-type straight laparoscope insertion guide for observation. Laser observation unit to evaluate bacterial clearance level: A rinse water circulation circuit for observation was designed to lead rinse water present in the gastrointestinal tract after clearance with the high-speed cleaning device onto a slide glass with a microguide for rinse water supply. It is possible to evaluate the microscopic contamination level of rinse water in the gastrointestinal tract that is delivered onto the slide in a real time basis by setting the circuit tip to the water supply nozzle of an endoscope for NOTES. The laser unit uses a digital image analyzer to distinguish bacteria from stool mass or epithelial cells of the gastrointestinal tract. The colon of 5 pigs was used to evaluate the macroscopic clearance level of the gastrointestinal tract and the bacterial count at the microscopic level. Consequently, we successfully verified the operable level for NOTES. This system was considered to be a useful tool for NOTES that requires the sterilization level of the gastrointestinal tract.
Program Number: P272