The heater probe: A new endoscopic method for stopping massive gastrointestinal bleeding

Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding using evidence‐based methods. The major cause of non‐variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug‐related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)‐related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first‐line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research.

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“…A heater probe is a contact thermocoagulation device . Contact thermal probes are based on the principle of coaptive coagulation.…”

Section: Endoscopic Hemostasismentioning

confidence: 99%

“…A heater probe is a contact thermocoagulation device. 87 Contact thermal probes are based on the principle of coaptive coagulation. The vessel is sealed by a combination of mechanical pressure and heat, which causes coagulation and thrombosis.…”

Section: Heater Probe Thermocoagulationmentioning

confidence: 99%

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Fujishiro

Iguchi

Kakushima

et al. 2016

Digestive Endoscopy

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“…The vessel-obliterating effect of the laser made it useful in the field of gastroenterology for the stoppage of severe bleedings in emergency cases. Neodymium:YAG lasers [4], argon ion lasers [ 5 ] , hot gas jets [6], and bipolar probes [7] have been applied to stop bleedings endoscopically. In ophthalmology, the argon ion laser has the potential of being used to treat retinal neovascularization [8].…”

Section: Introductionmentioning

confidence: 99%

Heat‐induced contraction of blood vessels

1982

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Heat-induced spontaneous contraction of blood vessels as observed during the application of surgical lasers was investigated experimentally. By means of extravascular irrigation of veins and arteries from the rabbit mesentery in vivo with saline that had been preheated to varying temperatures in the range of 45-90 degrees C, the temperature dependence on contraction with evaluated. It was demonstrated that lower temperature thresholds of approximately 70 degrees C and 75 degrees C exist for the shrinkage of veins and arteries, respectively. Ultrastructural investigation of the walls of contracted and of noncontracted vessels indicates that vessel contraction correlates with the denaturation of collagen fibrils. It was therefore concluded that the well-known heat shrinkage effect of denatured collagen accounts for the heat-induced vessel constriction. It is shown that on heat-induced permanent occlusion, vessels of the type that were examined cannot be achieved reliably at temperatures of up to 90 degrees C for 16 sec; in most cases relaxation takes place.

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“…Acute hemorrhage from the upper gastrointestinal tract is one of the most common medical emergencies. There is a wide range of hemostatic endoscopic therapies, including direct injection of agents that lead to blood clot formation into the bleeding vessel, 1–3 thermal methods 4,5 and mechanical devices, such as endoscopic hemoclips 6–8 . In earlier studies, it was suggested that the efficacy of each treatment was similar with reduction in the rates of rebleeding and emergency surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of Argon Plasma Coagulation in Patients With Upper Gastrointestinal Active Hemorrhage

Komatsu

Hara

Naito

et al. 2004

Digestive Endoscopy

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Background : Acute upper gastrointestinal hemorrhage is a common and life-threatening medical emergency. Despite a large number of endoscopic methods for hemostasis, active bleeding lacks an adequate therapeutic remedy. The aim of the present study was to evaluate the hemostatic effect of argon plasma coagulation on upper gastrointestinal active bleeding, especially in comparison with heater probe and pure ethanol injection therapy. Methods : Sixty-eight patients with 77 lesions presenting active bleeding were treated endoscopically and divided into three groups depending on the procedures, that is, argon plasma coagulation group (27 patients with 32 lesions), heater probe group (20 patients with 22 lesions) and pure ethanol injection group (21 patients with 23 lesions). The three groups were similar with respect to all background variables. Episodes of rebleeding were retreated with the same modality as used previously. Results : The primary hemostatic rate in the argon plasma coagulation group was 81.3%, that in the heater probe group was 77.3%, and that in the pure ethanol injection group was 87.0%. The permanent hemostatic rate in the argon plasma coagulation group was 75.0%, that in the heater probe group was 63.6%, and that in the pure ethanol injection group was 78.3%. When examined in terms of Forrest's criteria, the argon plasma coagulation group in Forrest's type I b and the pure ethanol injection group in type I a showed the highest permanent hemostatic rate. Conclusions : Argon plasma coagulation is most suitable in arresting oozing hemorrhage. If pure ethanol injection therapy is possible, it is more effective than other therapies in the case of spurters.

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The heater probe: A new endoscopic method for stopping massive gastrointestinal bleeding

Cited by 84 publications

References 8 publications

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Heat‐induced contraction of blood vessels

Effect of Argon Plasma Coagulation in Patients With Upper Gastrointestinal Active Hemorrhage

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