Endoscopic Hemostasis in Porcine Gastrointestinal Tract Using CO Low-Temperature Plasma Jet.

J Surg Res

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; Division of Metabolomics Research, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; AMED-CREST.

Published: February 2019

Background: Recently, atmospheric low-temperature plasma (LTP) has attracted attention as a novel medical tool that might be useful for achieving hemostasis. However, conventional plasma sources are too big for use with endoscopes, and the efficacy of LTP for achieving hemostasis in cases of gastrointestinal bleeding is difficult to investigate. In this study, to solve the problem, we developed a 3D-printed LTP jet that has a diameter of 2.8 mm and metal body for endoscopic use. The characteristics, hemostasis efficacy, and safety were investigated.

Materials And Methods: On investigating the basic characteristics of the developed plasma jet, the electron densities, gas temperatures, and reactive species were measured by emission spectroscopy and thermocouple. To evaluate the efficacy of such hemostatic treatment, porcine gastrointestinal bleeding was treated with the device. In addition, to investigate the safety of such treatment, the CO LTP-treated tissue was compared with tissue that was treated with clipping-based or argon plasma coagulation-based hemostasis for 5 d, and hematoxylin and eosin staining was used to evaluate tissue damage in the treated regions.

Results: The measurement of emission spectroscopy, power, and electron density of various gas plasmas suggested that a high-density (10 cm) LTP of CO was generated by the LTP jet, and the gas temperature was 41.5°C at 3 mm from the outlet of the LTP jet. The CO LTP achieved hemostasis of oozing blood by 70 ± 20 s. In addition, the CO LTP resulted in earlier recovery than clipping-based or argon plasma coagulation-based hemostases, and the treated regions had no damage by the CO LTP treatment.

Conclusions: These results indicated that the developed LTP plasma jet has the potential to be used for endoscopic hemostasis.

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http://dx.doi.org/10.1016/j.jss.2018.09.068DOI Listing

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