The heater probe: A new endoscopic method for stopping massive gastrointestinal bleeding

Abstract We have developed a heater probe which can be passed via an endoscope and which can apply pressure and heat simultaneously to a bleeding vessel. A 6.4-mm diameter prototype and a 3.2-mm diameter working model of this device have been tested for efficacy in stopping massive bleeding in experimental canine gastric ulcers. Randomized, internally controlled experiments were carried out at laparotomy in heparinized dogs using standard-sized gastric ulcers made and treated via an ample gastrotomy. In acute experiments the heater probe stopped bleeding from all treated ulcers, whereas all untreated control ulcers continued bleeding. In chronic studies performed at sterile laparotomy the depth of injury produced by heater probe coagulation was systematically evaluated; dogs were killed at intervals from 1 week to 1 month. No perforations occurred, but histological injury was evident extending from the ulcer base to the serosa in 7 of the 18 ulcers treated with the 6.4-mm probe and in 2 of the 30 ulcers treated with the 3.2-mm probe. In a preliminary endoscopic experiment the 3.2-mm probe stopped bleeding in 18 of 19 acute experimental ulcers. Histological evidence of injury extending to the serosa occurred in six instances; no perforations occurred. The efficacy in stopping bleeding with this method is satisfactory, but the depth of injury should be reduced before considering application to human beings.