2018 Volume 60 Issue 1 Pages 14-20
[Background] Double needle fixation devices have generally been used in percutaneous endoscopic gastrostomy (PEG). In some cases, however, it is difficult to fix the stomach to the abdominal wall by this double needle fixation device due to limited available space, while a single needle fixation device can easily fix the stomach even in such cases. In this study, we investigated the safety and usefulness of a single needle fixation device in comparison with a double needle fixation device.
[Materials and Methods] In the first fundamental experiment, a T-fastener and double needle fixation device were fixed to a metal plate followed by traction with a force of 1N (kg・m/s2), and the slack was measured as time elapsed. The second fundamental experiment was to test the durability of the devices, in which strings fixed to the pig stomach by both fixation devices were continuously pulled with increasing force. In a clinical trial, both fixation devices were used during PEG in the same patient, and the fixation time and slack as time elapsed were measured. In another clinical trial, PEG with three-point fixations was performed with a single needle or double needle fixation device, and the operation time and adverse effects were prospectively evaluated.
[Results] In the first fundamental experiment, there was no remarkable slack as time elapsed with both fixation devices. There was no difference in durability between the single needle and double needle fixation devices, and there was no damage in the pig stomach with either device. In the first clinical trial, the fixation time of the single needle fixation device was shorter than that of the double needle fixation device, and there was no remarkable slack as time elapsed with either device. Furthermore, there were no complications associated with PEG using either fixation device.
[Conclusion] The single needle fixation device seems to be a feasible device for conventional use during PEG.
