Abstract
The aim of this study was to evaluate the feasibility of a novel bracing basket for Endoscopic submucosal tunnel dissection (ESTD), which was developed for improved effectiveness and ease of use. This was a prospective randomized, comparative, experimental animal study carried out at a single center. The primary aim was to evaluate the efficacy of ESTD with a novel bracing basket, compared with conventional ESTD. The secondary aims were to assess the quality control of the procedures and adverse events. Twenty procedures (6 esophageal and 14 gastric) were performed in four pigs. All resections were completed as en bloc resections. The technical success rate was 100% for both techniques (bracing basket-assisted ESTD vs. conventional ESTD). The procedure times were similar, but the cutting speed was quicker with bracing basket-assisted ESTD in gastric (antrum:23.3 ± 2.2 mm2/min vs. 15.2 ± 3.2 mm2/min, body: 26.1 ± 1.3 mm2/min vs. 18.4 ± 2.0 mm2/min, p < 0.05). There was one bleeding in the bracing basket-assisted ESTD group and one perforation in the conventional ESTD group. Compared with conventional ESTD, the use of this basket has potential advantages. Comparison studies with larger gastric or colorectal lesions treated with conventional ESTD are needed.
Highlights
Endoscopic submucosal tunnel dissection (ESTD) was first described in humans in 2010 by Inoue et al for conducting peroral endoscopic myotomy[1]
A major issue often encountered with large superficial tumors in the GI tract is maintaining an inadequate view during ESTD because the mucosa cannot be lifted, as in open surgery, which leads to difficulties in cutting the edges, especially the gravity side
Inspired by the ERCP stone extraction basket, a new device makes for cutting the edge of the lesion to avoid complications, and it can determine the tunnel on both sides of the separation range; endoscopy can enter the tunnel for further separation
Summary
Endoscopic submucosal tunnel dissection (ESTD) was first described in humans in 2010 by Inoue et al for conducting peroral endoscopic myotomy[1]. It was proposed in esophageal and gastric for superficial cancer[2,3]. A major issue often encountered with large superficial tumors in the GI tract is maintaining an inadequate view during ESTD because the mucosa cannot be lifted, as in open surgery, which leads to difficulties in cutting the edges, especially the gravity side. The aim of this study was to evaluate the feasibility of a novel bracing basket for Endoscopic submucosal tunnel dissection (ESTD), which was developed for improved effectiveness and ease of use
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