LAUSR

AGPs, particularly in upper gastrointestinal endoscopies. 2,4-11 Many are variations of the head enclosures, including boxes made from Perspex referred to as Endoshield, 2 Endoscopic shield, 5 and En-doprotector, 6 and some with negative pressure. 4,7 Other methods are modifications of the mouth guard. An innovative device that is commercially available, the B1 mouthpiece (MPC-ST; Fujifilm, Tokyo, Japan), utilizes a sponge-fitted mouth guard with a slit for the endoscope attached to a face shield. 8 This has been shown to reduce aerosol scattering significantly, but not for aerosols ≤1.0 µm. 8 Hikichi et al., 10 in the latest issue of Clinical Endoscopy , reported on a novel mouthpiece which consisted of a conventional mouth guard and a hat-shaped attachment that has a large flange that covers the gaps between the mouth guard and angles of the mouth. This aerosol droplet guard acts as a valve that prevents aerosolized droplets being ejected from the mouth. 10 There was another report on a very simple technique using a cut part of a rubber glove placed over the external part of the mouthguard to act as a valve. 11 We also considered this technique, but in our case the valve part was inverted in-2022