We offer two CO2 insufflators for GI Endoscopy: the EVA15 and the EVA5

The EVA15 advanced CO2 insufflator monitors and maintains lumenal pressure within the GI tract during procedures within +/- l mm Hg. It does this via disposable tubing which connects from the insufflator to the endoscope instrument channel port. During the procedure, if the EVA15 reads a lower pressure than what was set, it automatically adds CO2. Conversely, if the unit reads a higher pressure, either due to manual insufflation or the application of argon gas during coagulation, the EVA15 evacuates the air through and in-line ULPA filter.

The EVA5 is a continuous-flow CO2 insufflator which connects to the endoscope water bottle and provides CO2 during manual insufflation. There are four flow settings to allow the physician to supply the appropriate rate of insufflation for the specific procedure.

EVA15 for Endobariatrics Using PABI(Physician Activated Bilevel Insufflation)

Why EVA15 for endoscopic weight loss procedures like ESG and POSE?

During endoscopic bariatric suturing procedures, the correct gastric lumenal pressure is critical for improving efficiency and outcomes. During the procedure, the lumen is expanded and collapsed multiple times while acquiring and suturing tissue.

With Physician Activated Bilevel lnsufflation (PABI), the physician is able to set a upper pressure and a lower pressure, while switching between the two with a footswitch. The physician now has full control and has the ability to change pressures to manipulate the anatomy as needed. This reduces communication requirements, increases procedural efficiency, and allows the physician to conduct the procedure in a more controlled manner.

Why EVA15 for TORe?

During the Transoral Outlet Reduction endoscopy (TORe) procedure, the physician first ablates the edge of the gastric outlet to help it narrow and close when the outlet is sutured to reduce the outlet size. When ablating with Argon Gas Coagulation (APC), the argon increases the gastric pressure and also creates surgical smoke.

As the sleeve pressure increases, the EVA15 insufflator recognizes this increase and begins to evacuate both the CO2 and the surgical smoke through the ULPA filter, creating the appropriate pressure in the sleeve and cleaner air within the endoscopy room.

Additionally, the principles of maintaining a high and low pressure using PABI when performing the outlet reduction assist in monitoring and maintaining the appropriate pressure throughout the procedure.

Why EVA15 for gastric ablation?

A relatively new procedure called Gastric Mucosal Ablation (GMA) is being studied as a primary endoscopic bariatric treatment. GMA uses Argon Gas Coagulation (APC) to ablate a majority of the mucosa within the stomach. The delivery of argon can increase the gastric pressure and the ablation itself creates significant surgical smoke.

As the gastric pressure increases, the EVA15 insufflator recognizes this increase and begins to evacuate both the air and the surgical smoke through the ULPA filter creating a more appropriate pressure within the stomach, and maintaining cleaner air within the endoscopy suite.

EVA15 for TIF/cTIF Using PABI(Physician Activated Bilevel Insufflation)

During Transoral lncisionless Fundoplication (TIF) the correct gastric lumenal pressure is critical for maximum efficiency and improving outcomes. During the procedure, the gastric lumen is expanded and collapsed multiple times while acquiring tissue and fastening the tissue with the device.

With the EVA15 and Physician Activated Bilevel lnsufflation (PABI), the physician has full control over the pressure and has the ability to change pressures to manipulate the anatomy as needed.

This reduces communication requirements, increases procedural efficiency, and allows the physician to conduct the procedure in a more controlled manner.

EVA15 for Surgical Endoscopy

As the lines blur between endoscopy and surgery, EVA15 is the insufflator of choice for surgical endoscopists and endoscopic surgeons. As a fully featured laparoscopic insufflator, EVA15 can insufflate the surgical cavity via a Veress needle. This maintain the desired pressures and affords optimal visualization whenever the endoscope is situated within the GI lumen or peritoneal/retroperitoneal cavity.

Because EVA15 employs active pressure reduction as part of its pressure control algorithm, it is differentiated from standard surgical insufflators, which typically only evacuate the lumen when it is over-pressurized during an alarm condition.

Watch video of EVA15 using PABI in action

EVA5 Continuous-Flow Insufflator for Advanced and General Endoscopy

Why EVA5 for advanced endoscopy procedures such as POEM?

During advanced GI endoscopy procedures, such as POEM, the ultra-low flow setting provides the lowest continuous CO2 insufflation flow rate in the industry at 0.8 liters per minute. This allows the physician to safely insufflate through the endoscope and perform the procedure while maintaining visualization within the tunnel.

Why EVA5 for general GI and other endoscopic procedures?

During other GI endoscopy procedures, the EVA5 has three other flow settings to allow for robust continuous CO2 insufflation flow up to 3.6 liters per minute. This allows the physician to insufflate through the endoscope for larger lumens such as the esophagus, stomach, duodenum, and colon.