Video small bowel enteroscopy: early experience with a prototype instrument.

A commercial grade of India ink was used and prepared in the following manner: Higgins black India (4418) waterproof drawing ink was diluted with sterile bacteriostatic water in a ratio of 5 parts ink to 2 parts water. This was done to allow the ink to pass through a filter more easily. Ink (114 ml) was mixed with 46 ml of water in a 250-ml Vioflex bag. The solution was then passed through a Travenol 5-/-Lm pore size particulate filter into sterile lO-ml vials to remove any large particulate material. The vials were then autoclaved for 40 min. Sterility of opened vials was 2 hours in duration, and unopened vials were considered sterile for 6 months. Colonic injection catheters (Wilson Cook Inc., WinstonSalem, N.C. or Olympus Corporation of America, Lake Success, N.Y.) were used with a 3-ml syringe to inject 0.1 ml of ink into the submucosa at points just proximal and distal or to the right and left of the excised lesion after the polypectomy in order to bracket the area to be re-examined (Fig. lC). If this area is within the reach of a flexible sigmoidoscope, esophageal variceal injection needles can be used.