How To...

PART 1 Oral cavity, pharynx and esophagus

GI Motility online (2006) doi:10.1038/gimo96
Published 16 May 2006

How to set up and manage a motility laboratory

R. Shaker, M.D. and C. Hofmann, R.N.
 About the contributors

The aim of the "How To..." section is to provide guidance on how to perform a range of procedures used for evaluation of patients with motility-related upper GI tract disorders. Each procedure is demonstrated by a video.

These "How To..." presentations are intended to cover only the basic principles of the techniques involved; safe and effective performance must be learned with guidance from a skilled practitioner.


Setting up a Motility Laboratory

The equipment and personnel needed to set up a motility laboratory and conduct motility and pH recordings are described below.

There are several brands of motility recording equipment. The performance characteristics and extent of recording ability of these devices differ and needs to be considered depending on the need of the individual laboratory.

Basic Equipment/Supplies

  • Adequate private room for performing the test with nearby restroom facilities
  • Sink with double basin and cleaning bins for decontaminating and sterilizing recording catheters
  • Adjustable bed as water perfused systems need level of patient to be equal to level of transducers
  • Refrigerator for storage of medications
  • Telephone
  • Code 4 wall button and nearby crash cart
  • Radiology viewing box for reviewing esophageal x-ray films
  • Motility equipment
  • Clock with second hand
  • Sharp object container
  • Step stool for patient
  • Chairs for physician/tech, patient, and family
  • Manometric recording tubes
  • Storage rack or cabinet for catheters
  • Storage cabinets to keep the following supplies, one locked cabinet for provocative testing medications that do not require refrigeration.
  • Tie gowns, robes, tissue, 6-inch cotton applicators, gloves, Xylocaine gel, emesis basins, towels, wash clothes, fitted sheets, pillow cases, 1000-mL bottles of sterile water for perfusion pump, absorbent Chux pads, sterilization solution, germicidal wipes, endozime, Surgilube, syringes and needles, IV sets, tourniquet, alcohol wipes, Band-Aids, tape, sterile water and sterile saline, 30-mL vials for injection and reconstituting medications, CCK, atropine, amyl nitrite, flashlight, adhesive tape remover, tongue depressor, gauze 4times4, catheter tip adapters, EMG stickers, batteries, air freshener, and nutritional supplements
  • Patient weight scale
  • Blood pressure/pulse oximeter machines
  • Procedure record keeping tool (record book or database)
  • Laundry bin


Procedure for the Disinfection and Cleaning of Manometric Recording Tubes and Perfusion Pump

Esophageal and upper esophageal sphincter manometric recording tubes:

  • Place tube in endozime solution for approximately a half-hour and carefully wipe external surface of recording tube with washcloth. Perfuse endozime in each port with solution, at least 5 cm3 in each port using a 10-cm3 syringe.
  • Rinse with water internal and external ports.
  • Place tube in 14–day activated dialdehyde solution bin.
  • Perfuse each port with activated dialdehyde solution.
  • Soak for 45 minutes as recommended in instructions.
  • Thoroughly rinse with water internal and external ports.
  • Drain and hang to dry.

Cleaning/disinfection of perfusion pump system:

Once per month:

  • Fill water chamber halfway with activated dialdehyde solution.
  • Perfuse one quarter of the solution through capillary and transducer system; turn pump off and soak for 45 minutes.
  • Empty chamber of the remaining activated dialdehyde solution and rinse chamber with water.
  • Fill chamber with sterile water and perfuse one half of the chamber.
  • Disconnect and again rinse chamber with water.
  • Record on data sheet when complete.

Activated dialdehyde: change every 14 days; mark with permanent marker on bottle when it needs to be changed and record on data sheet.


Personnel Commonly Needed to Conduct Motility and pH Recordings

  • Licensed physician for interpretation of motility recording
  • Trained technician or registered nurse to help perform motility tests
  • Scheduling coordinator