Letter to the Editor
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 16, 2021; 13(4): 111-114
Published online Apr 16, 2021. doi: 10.4253/wjge.v13.i4.111
Vinyl bag cover method to avoid droplet-containing aerosol escape from endoscopic forceps channel caps during COVID-19 pandemic (with Video 1 and Video 2)
Kazuya Akahoshi, Shinichi Tamura, Kazuaki Akahoshi, Yoriko Kaneshiro, Reiichi Sashihara, Kento Uemura, Kenta Sato
Kazuya Akahoshi, Shinichi Tamura, Kazuaki Akahoshi, Yoriko Kaneshiro, Reiichi Sashihara, Kento Uemura, Kenta Sato, Endoscopy Center, Aso Iizuka Hospital, Iizuka 820-8505, Japan
Author contributions: Akahoshi K designed the method; Akahoshi K, Tamura S, Akahoshi K, Kaneshiro Y, Sashihara R, Uemura K and Sato K conducted research; Akahoshi K (the first author) wrote the letter.
Conflict-of-interest statement: Authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kazuya Akahoshi, MD, PhD, Chief Doctor, Director, Endoscopy Center, Aso Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan. kakahoshi2@aol.com
Received: December 24, 2020
Peer-review started: December 24, 2020
First decision: January 25, 2021
Revised: February 6, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: April 16, 2021
Abstract

Endoscopists are at high risk of allowing transmission of coronavirus disease 2019 (COVID-19) during gastrointestinal endoscopy (GIE) procedures under pandemic conditions. The main avenues of droplet-containing aerosol generated during GIE are the mouth, anus, and endoscopic forceps channel. Although the usefulness of personal protective equipment for preventing COVID-19 dissemination has been well reported, measures to address infected aerosol escaping during endoscopic forceps use have been neglected. Pathogen-contaminated aerosol from the endoscopic forceps channel, leading into the gastrointestinal lumen, has been confirmed and is a highly problematic source of infection. We developed a technique that entails covering the forceps entry/exit hole with a vinyl bag, thereby preventing contamination of the endoscopy room by the infected aerosol that escapes from this hole. The technique can be used in daily clinical endoscopic practice. Furthermore, this shielding technique is useful for all patients who undergo GIE, regardless of the purpose of the procedure such as for making a diagnosis, administering therapy, or in an urgent situation. In this letter, we introduce our novel, easily performed, inexpensive method of infection prevention by disallowing infected aerosol to escape from a COVID-19-infected patient into the air during a procedure that requires the use of endoscopic forceps.

Keywords: Vinyl bag, Droplets, Endoscopy, COVID-19, Infection, Contamination

Core Tip: The world is experiencing a viral pandemic. The main avenues of droplet-containing aerosol generated during gastrointestinal endoscopy are the mouth, anus, and endoscopic forceps channel. Although the usefulness of personal protective equipment for preventing coronavirus disease 2019 dissemination has been well reported, measures to address infected aerosol escaping via endoscopic forceps use have been neglected. We developed a technique using a vinyl bag to cover the hole through which forceps enter the gastrointestinal lumen. It prevents endoscopy room contamination by disallowing infected aerosol to escape via the forceps entrance. It thus protects the endoscopy room and staff during endoscopy.