Post written by Ryota Sagami, MD, from the Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan.

This device is a plastic cube with sides of 45 centimeters. Four square plastic plates were glued together. With the patient in a left lateral position, the foot side and left side of the cube are open, and the head of the patient is covered, especially on the facial side. In our situation, a 170-cm tall endoscopist performed upper gastrointestinal endoscopy on a mannequin. The facial side of the cube contains 2 small holes, each 2 cm in diameter, and the endoscope is inserted through one of the holes, selected according to the size of the patient’s face and the height of their mouth. The other hole is closed with medical tape. A single episode of reflex vomiting or cough was simulated by bursting a small nitrile rubber balloon containing 10 ml of fluorescent dye. Simulated endoscopy was then performed without and with placement of the Endoscopic Shield. The scene for each simulation was illuminated with ultraviolet light to visualize the area of scattered dye droplets.

In the situation without the Endoscopic Shield, dye was clearly identified on various parts of the endoscopist. Contamination of the floor occurred within approximately 1.5 m from the head of the bed. With the Endoscopic Shield, most dye was identified on the inner front surface of the cube, on the inner upside surface to a lesser extent, and not on other surfaces. A little dye was found only on the endoscopist.

The Endoscopic Shield could prevent widespread dispersion of aerosol droplets on healthcare personnel including endoscopists and surrounding environments such as floors, which were exposed only slightly with Endoscopic Shield use. Therefore, the Endoscopic Shield may reduce the spread of COVID-19 infection during endoscopy.

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