A New Technique for Endoscopic Esophageal Mucosectomy Using a Transparent Overtube with Intraluminal Negative Pressure (np‐EEM)

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Abstract: We devised a new technique for endoscopic esophageal mucosectomy using a transparent overtube (OT) with intraluminal negative pressure (np‐EEM) (Figs. 1,2). Basic studies were performed on six dogs. The following two methods were utilized in the np‐EEM technique in line with standard approaches used for mucosal resection: (1) A “snare” method was used in which the esophageal mucosa protruded, similar to a polyp, through the slit of the OT and was resected by an electro‐snare passing through the endoscope biopsy channel or the injection channel of the OT. A high‐frequency current was used for the resection (Figs. 2‐a 2‐b, Fig. 3, Color). (2) A “cutter” method was used in which the mucosal protrusion was resected by a recently developed electro‐cutter (Figs. 2‐a, 2‐c, 2‐d, Fig. 3, Color).A mucosal protrusion, similar to a polyp, can be caused by intraluminal negative pressure at any point in the esophageal area. Mucosa up to 1.5 cm in diameter can be resected by both methods (Tables 1, 2; Figs. 5, 6, 7). The cutter method showed many advantages in terms of the ease of procedure, predictablility, and the ability to control the width and depth of the resection.Therefore, np‐EEM, especially using the cutter method, has significant advantages for application with esophageal mucosal lesions for both diagnosis and treatment.