Solo-RBT: A new instrument for rectal suction biopsies in the diagnosis ofHirschsprung's disease

Background/Purpose: Preoperative histochemistry on rectal mucosal-submucosa l specimens is the most important step in the diagnosis of Hirschsprung's d isease and other dysganglionoses. Today, rectal mucosal-submucosal biopsy s pecimens are obtained by suction with the widely used tool first designed b y Noblett in the late 1960s. The authors developed a new instrument, for wh ich a patent has already been filed, for one-hand execution of rectal sucti on biopsies, which will make this operation easier and faster. Methods: The authors modified the old tool but maintained the cutting metho d described by Noblett. The authors' innovative automatic tool (Solo-RBT) i s based on the possibility of sequencing suction and cutting of the rectal mucosa just by pressing a "trigger." The trigger activates a plunger to obt ain the vacuum necessary for the suction and a cutter for mucosal sampling. To perform a correct biopsy in children with different weight and in adult s, Solo-RBT can be adjusted suitably to obtain automatically the vacuum req uired in each case. Additionally, this tool is provided with 2 different si zes of both capsules and cutters, and it can be disassembled completely for easy cleaning, maintenance, and sterilization. Results: The instrument was tested clinically on 62 children (189 biopsies) , and it proved to be versatile, atraumatic, and extremely handy, because i t can be used by just 1 physician who only needs to press the trigger to ob tain the biopsy. Conclusions: Solo-RBT not only maintains the benefits (atraumatic, easy to use, rapid) and the main characteristic (cutting system) of Noblett's tool but it also improves its features and eliminates most of its disadvantages. Therefore, Solo-RBT represents a significant improvement in the diagnosis of Hirschsprung's disease and other dysganglionoses. J Pediatr Surg 36:1364 -1366. Copyright (C) 2001 by W.B. Saunders Company.