Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

Abstract

Background High‐resolution colonic manometry is an emerging technique that has provided new insights into the pathophysiology of functional colorectal diseases. Prior studies have been limited by bulky, non‐ambulatory acquisition systems, which have prevented mobilization during prolonged recordings. Methods A novel ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry was developed. Benchtop validation against a standard non‐ambulatory system was performed using standardized calibration metrics. Clinical feasibility studies were conducted in three patients undergoing right hemicolectomy. Results Pressure profiles obtained from benchtop testing were near‐identical using the ambulatory and the non‐ambulatory systems. Clinical studies successfully demonstrated ambulatory data capture with patients freely mobilizing postoperatively during continuous recordings of >60 hours. The occurrence (P = .56), amplitude (P = .65), velocity (P = .10), and extent (P = .12) of colonic motor patterns were similar to those obtained in non‐ambulatory studies. Conclusions A novel ambulatory system for high‐resolution colonic manometry has been developed and validated. This technique will facilitate prolonged ambulatory recordings of colonic motor activity, assisting with investigations into the role of colonic motility in disease states.

Hyperactive Distal Colonic Motility and Recovery Patterns Following Right Colectomy: A High-Resolution Manometry Study

“…We have previously described the development and validation of this ambulatory unit, which patients are able to carry in a shoulder bag, similar to a Holter monitor. 22 Manometry data were acquired by both systems at a sampling frequency of 10 Hz. Data were stored on the acquisition system and downloaded for analysis after the completion of recordings for each patient.…”

Post‐operative ileus: definitions, mechanisms and controversies

“…Further investigation of post-operative motility is needed to determine the precise abnormalities contributing to POI and PPOI, which may lead to the development of novel biomarkers, and targeted therapeutic or preventative strategies. Several novel techniques for recording of GI motility have recently been developed, including ambulatory HR colonic manometry, 47 cutaneous recordings of GI electrical activity 34,48,49 and magnetic resonance imaging assessment of small and large bowel motility. 50,51 Data from rodent models have described an early neurallymediated phase of ileus, lasting for 3-4 h post-operatively.…”