The Use of 2TQ260M Endoscope with Bipolar Needle Knife (B-Knife) and Insulation-Tipped Knife (IT-Knife) Could Facilitate Endoscopic Submucosal Dissection (ESD) Procedure

Abstract

Background and aims: We have demonstrated new and safe techniques to facilitate the procedures of endoscopic submucosal dissection (ESD) for early gastric cancer. The use of the bipolar-knife (B-knife, Xemex Co. Ltd.) and the insulation-tipped diathermic knife (IT-knife, Olympus Optical Co. Ltd.), the procedures of ESD have become easier and safer. In this study, we retrospectively analyzed whether the use of newly developed 2TQ260M endoscope (Olympus Optical Co. Ltd.), which has two channel forceps whole, multi bending function and water jet channel could facilitate the ESD procedure. Methods: Thirty three cases which underwent endoscopically resected gastric adenoma or carcinoma between November 2005 and October 2006 were retrospectively analyzed. ESD was performed using conventional endoscope “Q260” or newly developed “2TQ260M” (Olympus Optical Co. Ltd.) with B-knife and IT-knife. Size of the total resection area in specimen, size of the tumor in specimen, surgery time, one piece complete resection rate and complications were analyzed between Q260 and 2TQ260M groups. Results: Out of 33 cases by using both B-knife and IT-knife, 18 cases were used Q260 and 15 cases were used 2TQ260M scope. Average size of the total resection area was 1094/936.3 mm2, average size of the tumor was 274.1/144.3 mm2, surgery time was 1.59/1.42 hours and one piece complete resection rate was 83.3/93.3% in Q260 and 2TQ260M group, respectively. There was one case which could not undergo ESD because tumor was located in the difficult part in Q260 group. Regarding the complications, there was no perforation nor sever bleeding case in both group. Considerations: Using the newly developed 2TQ260M with B-knife and IT-knife for ESD made surgery time shorten and increased one piece complete resection rate, suggesting that this method could facilitate the ESD procedure.