Double-Balloon Platform Facilitates Internal Appendectomy

A disposable system that attaches to a traditional standard endoscope allows an appendectomy procedure to be performed completely within the intestine.

The Lumendi (Westport, CT, USA) DiLumen Endolumenal Interventional Platform (EIP) consists of a soft, flexible sheath that fits over standard and small diameter endoscopes. The device employs two balloons, one behind the bending section of the endoscope and the second in front of the tip. The double-balloon design improves the navigation of the endoscope through the bowel. When in position, both balloons are deployed and inflated, and the area in between the balloons is stabilized, creating a therapeutic zone that facilitates stabilization, insufflation, and manipulation of the tissue.

This allows the clinician to more effectively treat the target area and minimize potential mucosal injury, and also eliminates the need for incisions or punctures of the abdominal wall, lessening the risk of post-surgical incisional hernias and intraperitoneal adhesions. The DiLumen EIP is compatible with most standard endoscopes; it also incorporate two six mm diameter tool channels, which accommodate independent flexible articulating hand instruments, such as graspers and dissection tools. Once the therapy is complete, the balloons are simply deflated and removed, along with the endoscope.

“This novel endoscopic procedure will reduce post-procedure pain, will eliminate the need for hospital admission, and will assure an earlier return to work and regular physical activities,” said Sergey Kantsevoy, MD, PhD, director of therapeutic endoscopy at Mercy Medical Center (Baltimore, MD, USA), who performed the procedure. “It also eliminates the need for incisions or punctures of the abdominal wall, lessening the risk of post-surgical incisional hernias and intraperitoneal adhesions.”

“This new intervention demonstrates the options provided by the DiLumen platform,” said Dr. Peter Johann, Chairman and CEO of Lumendi. “Our focus is now on expanding the scope of DiLumen and DiLumen C2 beyond complex polyps, pre-cancerous lesions, and non-invasive early cancers of the lower GI tract.”

An appendectomy is a surgical procedure in which the vermiform appendix is removed. It is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis, and is usually performed laparoscopically; in some cases, such as the extremely obese, open surgery is preferred. In recent years, single-port transumbilical laparoscopy, or embryonic natural orifice transumbilical endoscopic surgery (E-NOTES), has emerged as an attempt to further enhance cosmetic benefits and reduce morbidity.

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