Enhancing emergency endoscopy efficiency with an additional suction channel: In vitro assessment

Emergency endoscopic interventions for upper gastrointestinal hemorrhage are frequently hampered by presence of blood clots and food debris. This study aimed to assess whether integration of an additional suction channel (ASC) onto a standard gastroscope enhances efficiency of aspirating clots and viscous fluids. A 5.3-mm suction catheter was used as an ASC mounted on a 2.8-mm standard gastroscope. Suction efficacy was evaluated using gastroscopes with working channel diameters of 2.8 mm, 3.7 mm, and 6 mm in vitro. Defined volumes of water, fruit yogurt, and coagulated blood were aspirated, and time required for complete evacuation was measured. Each setup was tested with and without the BioVac system. The ASC significantly enhanced suction performance across all test media. Notably, the 2.8-mm gastroscope with ASC outperformed all other configurations in aspirating water and yogurt. For clotted blood, the ASC significantly improved evacuation times compared with all other setups besides 6-mm + BioVac. A standard gastroscope equipped with an ASC significantly enhances suction performance in an in vitro model, outperforming gastroscopes with larger working channels. These findings warrant further validation in an ex vivo model to determine their clinical applicability.