Silicone Spigots for Segmental and Subsegmental Bronchi
Endobronchial Watanabe Spigots (EWS) were developed by NOVATECH in close cooperation with Dr. Y. Watanabe, Okayama, Japan. They are made of medical grade silicone (implantable for more than 29 days) dyed with barium-sulfate for excellent radiodiagnostic visibility. EWS are tapered and have an anatomical design with studs on the outside avoiding migration. They come sterile, individually blister-packed.
- persistent (even after successful pleural drainage), inoperable pneumothorax,
- bronchopleural fistula (especially following thoracic surgery) with a continuous loss of air despite thoracic suction drain, in cases in which surgical intervention is not indicated,
- temporary treatment of haemoptysis of peripheral origin in expectation of a bronchial arterial embolisation or surgery1).
A study performed in Japan with 63 patients including 40 cases of intractable pneumothorax, 12 cases of pyothorax with fistula and 7 cases of pulmonary fistula has shown that using EWS is safer and has more permanent positive results than conventional methods. After determination of the affected bronchi with a balloon catheter (alternatively X-ray etc.), the EWS are placed with a flexible bronchoscope and forceps guided by the working channel of the bronchoscope. EWS were successfully placed in 96.7 % of the cases. The loss of air was stopped or significantly reduced in 77.6 % of the cases. No severe complications ocurred 2).
- For certain patients bronchial occlusion with EWS can be envisaged as the only treatment. When it fails or the result is imperfect, pleurodesis (for example using STERITALC®) or other surgery (if not contra-indicated) can be considered.
- The spigots can be removed after the patient’s condition has improved and the thoracic drain is removed. If there are difficulties in removing EWS for any reason, removal is not necessary.
1)H. Dutau et al. Endobronchial Embolization with a Silicone Spigot as a Temporary Treatment for Massive Hemoptysis. Respiration DOI:101159/000092954, published online April 21, 2006
2) Watanabe Y. et al. Bronchial Occlusion with Endobronchial Watanabe Spigot, J Bronchol., 10, 4, 2003
Three sizes available:
S = ∅ 5 mm
M = ∅ 6 mm
L = ∅ 7 mm
3 × S, 6 × M, 3 × L
6 × S, ∅ 5 mm
6 × M, ∅ 6 mm
6 × L, ∅ 7 mm