Evis exera

An interventional pulmonologist or a thoracic surgeon performed all procedures. All procedures are performed either in endoscopy unit with moderate sedation or in the operation room (OR) under general anesthesia. We uniformly started bronchoscopies with airway examination by using a flexible bronchoscope (Evis Exera, BF-MP160F or BF-H190, Olympus, Tokyo, Japan) followed by EBUS examination (BF-UC180F convex probe EBUS ultrasound bronchoscope powered by Aloka ProSound F75 ultrasound processor, Olympus, Tokyo, Japan). A dedicated 22-gauge needle (NA-201SX-4022, Olympus) is used to perform transbronchial aspiration.

All procedures were performed at Olive View-UCLA Medical Center, a 377-bed safety net hospital and regional referral center serving the northern catchment area of the Los Angeles County Department of Health Services, the second largest municipal healthcare system in the United States. Many of the luminal stenting procedures performed at our institution are technical failures from outside facilities that are referred for a higher level of care. The average technical success rate for endoscopic luminal stenting at our institution has historically been > 95 %.
Between February 2018 and April 2018, 16 upper and lower endoscopies with luminal (gastroduodenal or colonic) stent placement were performed at our institution. In five of these 16 cases (31 %), a clear cap (3-mm length distal attachment, Olympus America, Center Valley, Pennsylvania, United States) was attached to the scope tip to salvage what would have likely otherwise been a technical failure. The remaining 11 cases (69 %) were successfully performed with conventional techniques without needing a cap. All procedures were performed with Olympus (EVIS EXERA, Olympus America) endoscopes, as detailed below.