Endoscopy
DOI: 10.1055/a-1187-1018
E–Videos

Novel technique using an echo probe cover prevents oral–fecal transmission of SARS-CoV-2 during urgent colonoscopies

Noriko Nishiyama
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
2  Department of Gastroenterology, Nishiyama Neurosurgery Hospital, Sakaide City, Japan
,
Hideki Kobara
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Naoya Tada
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Takanori Matsui
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Shintaro Fujihara
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Akira Nishiyama
3  Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
,
Tsutomu Masaki
1  Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
› Author Affiliations
 

While routine examinations are postponed during the COVID-19 pandemic, urgent therapeutic colonoscopies are mandatory for lower gastrointestinal (GI) bleeding and colorectal ileus. SARS-CoV-2 RNA has been identified in anal/rectal swabs and stools of COVID-19 patients, even after viral clearance from the upper respiratory tract [1] [2]. Feces often overflow during colonoscopy, leading to viral dissemination. Thus, a high risk of infection is associated with colonoscopy, as well as upper GI endoscopy [3]. Reported contamination of endoscopists’ face shields [4] indicates that endoscopy rooms become contaminated. A novel means of blocking patient – generated droplets is therefore required. We introduce a new precautionary technique using an echo probe cover to prevent oral–fecal transmission of SARS-CoV-2 during emergency colonoscopies ([Fig. 1], [Video 1]).

Zoom Image
Fig. 1 Overview of the new precautionary technique using the echo probe cover.

Video 1 New precautionary technique using an echo probe cover to prevent oral–fecal transmission of SARS–CoV–2 during emergency colonoscopies.


Quality:

An echo probe cover (14 × 147 cm, CIV-Flex Transducer Cover; Century Medical, Inc., USA), 13 × 8 cm piece of cardboard with 7 × 5 cm hole, and a diaper ([Fig. 2 a]) are applied to create a shield. First, the probe cover with a 1.2-cm hole, which provides endoscope access, is taped onto the reverse side of the cardboard through the 7 × 5 cm hole ([Fig. 2 b]). Wearing the prepared diaper and endoscopic examination pants, the patient lies in left lateral recumbency, and the cardboard is taped over a 4-cm hole in the diaper ([Fig. 3 a]). The endoscope is inserted via the open side of the probe cover. The probe cover is fixed with a clip on the proximal side of the endoscope. This method does not interfere with scope maneuvers during colonoscopy ([Fig. 3 b]).

Zoom Image
Fig. 2 Creating the shield. a A 14 × 147 cm echo probe cover, 13 × 8 cm piece of cardboard with 7 × 5 cm hole, and a diaper are used. b A probe cover with a 1.2-cm hole, which provides endoscope access, is taped onto the reverse side of the cardboard through the 7 × 5 cm hole.
Zoom Image
Fig. 3 The completed shield. a The cardboard is taped to a prepared 4-cm hole in the diaper. b This method does not interfere with scope maneuvers during colonoscopy.

Enclosing the endoscope within the probe cover helps to block aerosols and the diaper absorbs any droplets. These materials can be disposed of without scattering the virus into the surroundings. This method can effectively prevent viral transmission, as well as reducing endoscopists’ mental stress by providing protection against contamination.

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Competing interests

The authors declare that they have no conflict of interest.


Corresponding author

Noriko Nishiyama, MD, PhD
Department of Gastroenterology and Neurology, Faculty of Medicine
Kagawa University
1750-1 Ikenobe
Miki, Kita, Kagawa 761-0793
Japan   
Fax: +81-87-8912158   

Publication History

Publication Date:
19 June 2020 (online)

© Georg Thieme Verlag KG
Stuttgart · New York


Zoom Image
Fig. 1 Overview of the new precautionary technique using the echo probe cover.
Zoom Image
Fig. 2 Creating the shield. a A 14 × 147 cm echo probe cover, 13 × 8 cm piece of cardboard with 7 × 5 cm hole, and a diaper are used. b A probe cover with a 1.2-cm hole, which provides endoscope access, is taped onto the reverse side of the cardboard through the 7 × 5 cm hole.
Zoom Image
Fig. 3 The completed shield. a The cardboard is taped to a prepared 4-cm hole in the diaper. b This method does not interfere with scope maneuvers during colonoscopy.