Electrosurgical knife with the water-jet function of tip-type during endoscopic treatment injection.

Abstract

ObjectivesThis study aimed to objectively evaluate the water‐jet‐functioned electrosurgical knife injection performances in a desktop experiment.MethodsFive types of water‐jet‐functioned electrosurgical knives, including two injection styles of sheath‐type (A: DualKnife J, KD‐655L; B: FlushKnife, DK2620‐J‐B20S; C: Splash M‐Knife, DN‐D2718B; D: ISSEN, SN1650‐20) and tip‐type (E: ORISE ProKnife, M00519361) were evaluated. These knives were compared with an injection needle (Control: SuperGrip 25G) as a control. The injection speed under constant pressure and the injection efficiency for each knife against prepared porcine stomach mucosa were evaluated. The additional clear gel injections using an injection needle were observed using an indigo blue‐colored gel to evaluate the difference between the locations of water‐jet holes.ResultsFour types of knives, except for A, showed significantly higher water‐jet speeds (A: 0.79 ± 0.03 g/20 s, B: 2.56 ± 0.05 g/20 s, C: 3.09 ± 0.06 g/20 s, D: 2.86 ± 0.05 g/20 s, and E: 1.79 ± 0.03 g/20 s) compared to that of the control (1.21 ± 0.03 g/20 s). Meanwhile, significantly higher efficacy of injection was found in the tip‐type water‐jet function knife, second to the injection needle (Control: 37.2% ± 35.5%, A: 20.9% ± 20.2%, B: 1.1% ± 2.2%, C: 6.2% ± 12.6%, D: 12.5% ± 15.6%, and E: 33.3% ± 32.2%). An additional injection experiment revealed that the injection with a piercing tip into the gel could achieve sufficient additional injection inside the stacked clear gel.ConclusionsThe tip‐type water‐jet function electrosurgical knife is preferable for effective submucosal injection during endoscopic treatments.