A new device, LMA Gastro™, on the horizon for endoscopy procedures: A narrative review

Abstract

Interventional endoscopy procedures are challenging for anaesthesiologists due to the various patient, procedural, logistic, and position-related issues. Complex endoscopic procedures like biliary interventions and endoscopic myotomy necessitate longer procedural duration. The mode of anaesthesia is usually deep sedation without any definitive airway device and is frequently associated with hypoxemia events which can be catastrophic. An endotracheal tube, though the gold standard for securing the airway, would prolong the anaesthesia time and delay the recovery. The laryngeal mask airway Gastro™ is a novel supraglottic airway device specifically meant for these procedures as it provides access to the gastrointestinal tract simultaneously with a patent airway. Though its purported advantages are undoubted, its clinical usage has various pitfalls that can hinder its wider acceptance and practical utility, especially when newly introduced. The literature is limited on the feasibility of this device in both the ease of endoscopy and the prevention of hypoxemia. In this review, we have discussed the device’s properties, its varied use cases, the supporting evidence for the same, the caveats, and the future perspectives.

Keywords

• airway obstruction
• anaesthesia
• cholangiopancreatography
• deep sedation
• endoscopic retrograde
• endoscopy
• gastrointestinal
• hypoxia
• laryngeal masks