Colorectal endoscopic submucosal dissection using novel articulating devices: a comparative study in a live porcine model

• Published in: Surgical endoscopy Vol. 33; no. 2; pp. 651 - 657
• Main Authors: Okamoto, Yasuharu, Nakadate, Ryu, Nakamura, Shotaro, Arata, Jumpei, Oguri, Susumu, Moriyama, Tomohiko, Esaki, Motohiro, Iwasa, Tsutomu, Ohuchida, Kenoki, Akahoshi, Tomohiko, Ikeda, Tetsuo, Kitazono, Takanari, Hashizume, Makoto
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2019; Springer Nature B.V
• Subjects: Abdominal Surgery; Animals; Colorectal Neoplasms - surgery; Endoscopic Mucosal Resection - instrumentation; Endoscopic Mucosal Resection - methods; Endoscopy; Gastroenterology; Gynecology; Hepatology; Medicine; Medicine & Public Health; Models, Anatomic; New Technology; Proctology; Surgery; Swine; Treatment Outcome; Endoscopic submucosal dissection; Standard endoscope; Colon; Articulating device; ESD; Novel device
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-018-6408-5

Background and aims Colonic endoscopic submucosal dissection (ESD) is time-consuming and bears a high risk of perforation. The aim of the present study was to compare the safety and efficacy between novel articulating devices and conventional ESD in live porcine colon models. Methods Thirty ESDs in ten pigs were carried out at three different locations (15, 25, and 35 cm from the anus) by the conventional method ( n  = 15) and by the new method ( n  = 15). Procedure times, adverse events (perforation, bleeding), and damage to the muscular layer were recorded, and the ESD time per unit area of the specimens was calculated. Results The perforation rate using the conventional method was 6.7% (1/15), whereas that using the new method was 0.0%. The number of sites of muscular damage was significantly lower in the new than conventional method (6 vs. 37, respectively; P  = 0.024). The mean procedure time was significantly shorter in the new than conventional method (4.6 ± 2.0 vs. 7.0 ± 4.1 min/cm 2 , respectively; P  = 0.042). Conclusions Use of the new ESD method allows for reduced adverse events and a shortened resection time.