The feasibility of disposable video‐bronchoscopes, Ambu aScope3, for exploration of the common bile duct and extraction of stones

Abstract

Introduction The aim of this study was to assess and evaluate the feasibility of using the Ambu aScope3 (aScope) for common bile duct (CBD) explorations, stone detection and extraction, as well as to assess feasibility of its use through the laparoscopic ports in a low‐volume centre. Methods This is a dual centre prospective study, conducted between February 2015 and August 2019, of patients undergoing laparoscopic cholecystectomy and common bile duct exploration. Ethical approval was obtained from the North West ‐ Greater Manchester South Research Ethics Committee. All patients were counselled on the use of the aScope in clinic, prior to surgery. The Primary endpoints were the ability of the aScope to identify CBD stones, perform a cholangiogram through the available channel, retrieve the stones using a Dormia basket and to visualise second generation biliary radicles satisfactorily. The secondary endpoint was the use of the aScope, via a laparoscopic port without a gas leak. The data collected included patient demographics, need for a CBD exploration, intraoperative confirmation of CBD stones and their safe extraction using an aScope. Results A total of nine patients were recruited. The aScope provided satisfactory views in eight of nine patients and enabled the safe extraction of CBD stones in six of nine cases. One patient had a bile leak, and another had a transected CBD prior to the use of the aScope. Conclusion We found that the aScope is a safe, feasible alternative to a choledochoscope, and in a low‐volume centre, it provides a financially viable option.

Disposable Gastrointestinal Scopes: A Systematic Review

“…However, the scope’s resolution is not as good as conventional scopes, though high resolution is not necessary for CBD stone detection. Overall, they concluded the Ambu aScope3 to be a safe feasible alternative to a conventional choledochoscope 5 …”

“…A prospective study 5 assessed the feasibility of the disposable choledochoscope, Ambu aScope3, in CBD exploration and stone extraction. They found satisfactory views in 8 of the 9 patients and successful safe extraction of CBD stones in 6 out of 9.…”

“…Functionality was another common theme among these articles. Six articles (by Muthusamy et al, 8 Bang et al, 10 Lisotti et al, 11 Ross et al, 12 Kang et al, 13 and Forbes et al 17 ) demonstrated comparable functionality of disposable scopes to reusable scopes, whereas 4 articles (Kalipershad et al, 5 Ofosu et al, 7 Luo et al, 14 and Huynh et al 15 ) reported decreased functionality. The most reported functionality issue in disposable scopes was decreased camera resolution.…”

“…Overall, they concluded the Ambu aScope3 to be a safe feasible alternative to a conventional choledochoscope. 5…”

Single-Use or Disposable Flexible Bronchoscopy in Advanced Bronchoscopy Procedures: Experience in a Quaternary Referral Centre

“…Due to their ease of use, it is not surprising that other applications are being reported including abdominal and pleural access [18, 19]. It is surprising, however, that novel applications are being reported prior to rigorous evaluation in licensed procedures.…”