Reusable Design of Esophageal Band Ligation Device

Abstract

Background: Variceal bleeding is one of the fatal complications of portal hypertension. There are several remedies for this problem but all of them have their own side effects. The treatment of choice is "endoscopic band ligation" but the high cost of the available instrument on the context of its single use design, is considered its only disadvantage (1.600.000 rials per session). Therefore, many patients avoid purchasing the instrument.However, we decided to design a reusable device by reloading the original  one, using suitable elastic bands and sophisticated deployer nodes taking into account easy use and high efficacy of this treatment modality.

Materials and Methods: Instead of the available granules, a series of special and very suitable nodes was employed for stretching and deployment of the bands.Also, a conical piece was designed to insert bands on cap as a dilator. Hemorrhoid ligation bands (the product of Endo Flex, Germany) were used instead of bands of the original device.

Results: Ten node types were consequentially tested on sample and endoscopic device and if suitable, were tested on endoscope and patients thereafter. Node "61" was the fittest among (complete success rate in 429 deployments). The cost of new designed device is equal to 20.000 rials, which is very low compared to the original one.

Conclusion: The new designed reloadable band ligator instrument is very economic and according to accomplished experiments, it has the same quality as the original one. Then, it would be suitable for both patient and physician to use new instrument for endoscopic band ligation.