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