Is endoscopic mucosal clipping useful for preventing colonic manometry probe displacement?

Goal: To examine whether endoscopic mucosal clipping prevents probe migration. Background: Ambulatory colonic manometry can provide useful pathophysiologic information regarding colonic motor function. However, probe displacement during prolonged recording can be problematic. Methods: Thirty healthy volunteers underwent 24-hour ambulatory colonic manometry with colonoscopic-assisted probe placement, and fluoroscopic confirmation of the location of most proximal sensor at hepatic flexure. Participants were randomized to 2 groups; in 14 participants (m/f=8/6), the probe was anchored to the colonic mucosa using mucosal clips and in 16 participants, (m/f=9/7), the probe was left unattached in the colon. Magnitude of transducer displacement was assessed by fluoroscopic localization. The difference between the number of transducers in each segment at the beginning (x) and at the end (y) of each study was summed up and divided by 2, to calculate the "displacement score" and this was taken as the main outcome measure. Results: In participants without clipping, the mean (s.d.) displacement score was 1.6 (0.9), implying displacement of transducers by 1.6 colonic segments relative to their initial location. In contrast, there was no displacement of transducers in those who received clipping. Clipping caused no adverse events. Conclusions: Endoscopic mucosal clipping is safe and effective for prevention of probe displacement, and ensures more accurate temporospatial resolution of data for prolonged colonic manometry recording.