866 Safety and Efficacy of the Novel Endorotor® Mucosal Resection System: First Multicenter USA Experience

Abstract

INTRODUCTION: The EndoRotor® (ER) non-thermal tissue resection device (Interscope Inc., USA) is a novel mechanical endoscopic resection system developed for use in the gastrointestinal tract for removal of neoplastic or pre-neoplastic tissue. It utilizes adjustable suction and a rotary cutting blade to precisely resect mucosal and submucosal tissue. Our aim was to assess the technical feasibility, safety and efficacy of endoscopic mucosal resection (EMR) using the ER device. METHODS: This was an IRB-approved multicenter retrospective review of prospectively collected data of patients that underwent EMR with ER device from 11/2018 to 06/2019 at 4 high-volume US centers. Patient-specific data were collected including demographics and indication for EMR. Procedural and histopathological data were also obtained. RESULTS: During the study period, 35 patients underwent EMR with ER of 42 lesions. Patient characteristics described in Table 1. Most common indications for EMR were colon polyps (n = 15, 42.9%) and Barrett’s Esophagus (n = 10; 28.6%). Most (n = 25; 71.4%) patients had a prior resection attempt for the same indication using standard techniques; ER-EMR was successful in all these difficult cases. The majority (n = 32; 91.4%) had a single lesion resected; 3 patients had multiple lesions resected in same session. ER-EMR was technically feasible in all patients, with complete resection achieved in 33 (94.3%) patients (Table 2). Mean lesion size was 2.1 cm (range = 0.35–4 cm). Most frequent histopathological findings in the colon were tubular adenoma (n = 10; 45.5%) or sessile serrated adenoma (n = 5; 22.7%). Most common esophageal pathology in BE patients was high-grade dysplasia (n = 5; 50%). Intra-procedural bleeding was observed in 9 (25.7%) patients, all managed endoscopically. No ER-related perforation occurred. Post-procedural complications were reported in 7 patients (20%), including self-limited chest pain (n = 1), mild stenosis (n = 3), and delayed bleeding (n = 3). Of patients that have undergone a follow-up endoscopy (n = 13; 37.1%), no residual lesion was seen in majority (n = 10; 76.9%). CONCLUSION: The Endorotor® device is a novel, effective and safe non-thermal EMR technique that allows efficient endoscopic resection of flat and polypoid lesions, especially those with submucosal scarring. Our initial experience suggests it has a promising role in the endoscopic management of both naïve and difficult to remove luminal lesions in the foregut and in the colon.