P2730 - The Feasibility of Use of the EXALT Model-D Single Use Duodenoscope for ERCP Performed in an Outpatient Ambulatory Center

Richard Blosser, ¹, Allen Blosser, ^2
1The Gastroenterology Center of Virginia, Fairfax, VA; ²The EWLCA, Fairfax, VA

Introduction: The Boston Scientific EXALT single use duodenoscope was introduced as an alternative to existing reusable scopes.We evaluated the performance of the EXALT duodenoscope in an outpatient ambulatory surgery center (ASC) setting . We assessed the EXALT performance perimeters as compared to the endoscopic alternatives. We believe this critical assessment to be the first evaluation a single use duodenoscope in an outpatient ASC.

Methods: From March 25 , 2021 to June 17,2021 , eleven (11) patients were consented for elective outpatient ERCP evaluation at a free standing ASC. Enrollment criteria : no cholangitis , no active comorbidities ,
no evidence of sepsis , ASA Class I -II , ASA Class III only with clearances , and age between 18 -80. The indications , age , flouroscopy time, endoscopic findings , recovery time ,and complications were recorded. The EXALT scope performance on a scale 1-10 ( 1 poor 10 excellent ) was assessed with respect to ease of use , dial wheel performance ,channel use , optics , and video capture capabilities. All pts needing native sphincterotomy received pre-op antibx and post-op Indo 50 mg supp. Discharge times were noted and criteria included stable VS , no evidence of peritoneal findings, no complaints of abdominal pain , and tolerating diet.

Results: From March 25,2021 - June 17 , 2021 eleven ( 11) patients were enrolled by the same gastroenterologist in the same ambulatory outpatient facility
Indications: CBD stones 10 , stricture 1 , stent removal 8
Age range : 28 yo - 80 yo ( female 7 , male 4 )
Flouro time range : 35 s - 219 s ( mean 82 s ) Exposure : 10.1 mGy - 51.5 mGy ( mean 22.9 mGy )
Endoscopic findings : Stones 8 , sphincterotomy 3 , stent removal 8 , stent placement 3 , stricture 1
Discharge criteria : all discharged within 45 min of procedure completion
EXALT performance criteria : Ease of use : 10 Dial wheel ( stiffness ) : 9 Channel use : 10 Optics: 9 Video capture :8
Channel use ( to include ) : sphincterotomy , 9-12 mm balloon , 7F-10F stents , WallStent
Complications : None (0)

Discussion: The EXALT single use duodenoscope performed well in the ASC setting. There was no significant difference in procedure times , performance criteria , recovery time , findings , and potential complications with the EXALT duodenoscope when used in this setting. The excellent performance of the EXALT scope should be consider a positive factor in moving elective , nonurgent healthy patients needing ERCP from the hospital setting to an ASC setting in the near future.


Disclosures:


Richard Blosser, ¹, Allen Blosser, ². P2730 - The Feasibility of Use of the EXALT Model-D Single Use Duodenoscope for ERCP Performed in an Outpatient Ambulatory Center, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.