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Frequently Asked Questions > Sidehole Catheters


 
1: What features of the catheter determine patient tolerance of oesophageal intubation?
  Diameter, diameter - then flexibility. Therefore, for routine diagnostic use, choose a catheter diameter that is as small as is compatible with the use of standard manometric methods and which still has adequate rigidity. The flexibility of silicone rubber reduces the discomforts of intubation.

2: What catheter diameter/extrusion type does Dentsleeve recommend for routine oesophageal manometry?
  Our 4mm diameter 8+1 extrusion (E114); because it gives the best balance of diameter and stiffness. This is why we use this extrusion in our main range of oesophageal catheters. A reduction of catheter diameter of 0.7mm from 4.7 to 4.0 sounds very little, but it gives a major reduction of catheter cross sectional area.

3: What are the situations when standard 4mm diameter catheters might be unsuitable for oesophageal manometry?
  None really, since designs are available for passage over a previously placed guidewire in patients with moderate to major oesophageal dilatation. Guidewire stiffeners can also be passed into the core channel and retained there in catheters that have this channel closed at its tip (see special option available).

4: Why does Dentsleeve offer oesophageal catheters that have several different diameters?
  Because users have differing priorities and needs, and smaller diameter catheters are essential for paediatric and neonatal manometry. For example, one major surgical laboratory that we supply uses our 3.5mm diameter (E27) extrusion solely, because they want patients to return for follow-up research studies. Because the 3.5mm catheter is so well tolerated, most patients agree to subsequent studies.

5: Does the greater flexibility of silicone rubber catheters make oesophageal intubation more difficult than with PVC catheters?
  No, provided the correct type of catheter is used and the technique of intubation adapted slightly. This is shown by a now vast experience from clinical and research laboratories around the world, including achalasia patients(1,2).

6: How should intubation technique be adapted to suit silicone rubber catheters?
  Swallowing should be used as the primary driver and guidance for the catheter, at least until the catheter tip reaches the oesophagus. This is actually the best technique for all catheters, but some users prefer to rely mainly on pushing the catheter. Our silicone rubber catheters can be pushed, but not as forcefully as PVC catheters.

7: If silicone rubber catheters have a diameter less than 3.5mm, they become very flexible. How can they be passed successfully?
  The smaller the passage into which the catheter is being passed, the less rigid the catheter needs to be. So, what is too flexible for an adult is ideal for a neonate. When a catheter is too flexible for a particular application, it can be stiffened to some degree with an implanted nickel-titanium wire or sometimes a removable guide-wire (FAQ 3).

8: How should re-usable Dentsleeve catheters be cleaned and disinfected?
  After washing and syringing, catheters should be placed in an autoclave pouch and autoclaved at 134 degrees C and 206 kpa pressure for 5 minutes. The unique feature of autoclavability, according to this validated protocol and storage in a pouch, ensures sustained freedom from infection hazards from one use to the next.

 
  9: What is the 'zero dead space' luer connector on re-usable Dentsleeve catheters?
    This is a feature only available from Dentsleeve which ensures more easy and reliable measurements by eliminating the bubble trap at the connection to the transducer. These specifically designed connectors stretch over the male luer connector of the transducer, eliminating the bubble-trapping 'dead space' in this connection. All other luer connectors are rigid and are hidden bubble traps.

  10: What choices of oesophageal manometry catheters are available from Dentsleeve?
    Almost limitless, from 1 to even 32 channels! Our most common standard designs are described in our brochures and our website gives more detail. We also build catheters to special designs specified by the user, after working through the best design solution with that user.

  11: Which parts of Dentsleeve catheters contain latex?
    None, except for some balloons used for anorectal manometric catheters.