Open-pore polyurethane foam drainage is used for endoscopic negative pressure therapy
of the esophagus [1]. The vacuum stent (VacStent GI; Micro Tech, Nanjing, China) is coated with a voluminous
polyurethane foam [2].
An alternative drainage material for endoscopic negative pressure therapy is a very
thin, open-pore, double-layer, transparent drainage film [3]
[4]
[5]. The volume of material is minimal, and it can be used to produce very narrow, open-pore
film drainage devices with diameters of 4–6 mm [1].
This report describes in detail how a novel alternative vacuum stent can be manufactured
using the open-pore, double-layer film. Placement of the film in an over-the-scope
technique is demonstrated on an anatomical model.
The equipment and material required include a strip of the film (Suprasorb CNP Drainage
Film; Lohmann & Rauscher, Rengsdorf, Germany), a covered esophageal stent (e.g. partially
covered Hanarostent Esophageal Stent; M.I. Tech, Pyeongtaek, South Korea), drainage
tube (Argyle Ventrol Duodenal Tube 12 Fr/Ch; Covidien, Dublin, Ireland), and suture
(Mersilene; Ethicon, Raritan, New Jersey, USA) ([Fig. 1]).
Fig. 1 Materials required for creation of an open-pore, double-layer film-covered vacuum
stent. oF, open-pore drainage film (Suprasorb CNP Drainage Film; Lohmann & Rauscher,
Rengsdorf, Germany); ST, covered stent; Su, suture; T, drainage tube.
The stent is removed from the delivery device. The middle covered part is wrapped
with a strip of open-pore drainage film ([Fig. 2]
a). The drainage film is sutured ([Fig. 2]
b). The distal end of the drainage tube is inserted between the outside of the stent
and the film sleeve ([Fig. 2]
c). The drainage tube is fixed to the proximal end of the stent with a suture. The
drainage film is secured to the stent with sutures. The newly created vacuum stent
is then ready for use ([Fig. 2]
d, [Video 1]).
Fig. 2 Creation of the vacuum stent. a The middle covered part of the stent is wrapped in the drainage film. b The drainage film is fixed with a suture. c The drainage tube is inserted between the drainage film and the outside of the covered
part of the stent. d The newly created vacuum stent.
Creation of a vacuum stent, using open-pore, double-layer, transparent drainage film,
and over-the-scope placement.Video 1
No special delivery device is required. The vacuum stent can be inserted using an
over-the-scope method ([Video 1]). The distal end of an endoscope is introduced into the stent. The string loop at
the distal end of the stent is grasped and fixed with a grasping forceps. Then, the
drainage tube (proximal end of the stent) is pulled. This stretches the stent and
secures it over the endoscope. The introduction of the stent and placement in the
correct location is carried out under continuous endoscopic view. After oro-nasal
conversion of the drainage tube, vacuum is applied with an electronic pump.
With the open-pore, double-layer, transparent drainage film, any covered esophageal
stent can be converted into a vacuum stent. The vacuum can be applied over the entire
surface of the film coating. As the film is very thin, its application around the
stent changes the design of the stent only slightly.
Endoscopy_UCTN_Code_TTT_1AO_2AI
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy.
All papers include a high-quality video and are published with a Creative Commons
CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission
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