Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(09): E1187-E1191
DOI: 10.1055/a-0961-7542
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Usefulness of “Nelaton Attachment” for endoscopic submucosal dissection of colorectal neoplasms

Authors

  • Taiji Yoshimoto

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Hiroshi Takihara

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Tomoatsu Yoshihara

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Taro Inoue

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Kohei Ishibashi

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Masanao Uraoka

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Akihiro Nakamura

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Shinsuke Hiramatsu

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Shinichi Baba

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Shun Abe

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Ko Matsuura

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Masato Hoshikawa

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Rika Taketani

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Hironori Tanaka

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Kenichiro Motozato

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Yuji Tanigawa

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Eisuke Nakao

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Akitaka Yokomura

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Michihito Kono

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Kenji Kagari

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Akito Furuta

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Asuka Sunada

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Kenji Maejima

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Eri Tsuyuguchi

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Yasuo Yamasaki

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
  • Takahiro Shishimoto

    Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
Weitere Informationen

Publikationsverlauf

submitted 05. September 2018

accepted after revision 12. März 2019

Publikationsdatum:
29. August 2019 (online)

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Abstract

Background and study aims Although colorectal endoscopic submucosal dissection (ESD) has enabled high en bloc resection rates regardless of tumor size, colorectal ESD is still a challenging procedure. We developed a novel device called the Nelaton Attachment, which allows endoscopists to manipulate the ESD knives using two fingers of their left hand while holding the endoscope with their right hand. We retrospectively investigated the efficacy and safety of the Nelaton Attachment for colorectal ESD. We compared efficacy and safety between Nelaton Attachment and non-Nelaton Attachment groups, and also conducted an ex vivo experiment to evaluate the effect of the Nelaton Attachment.

Patients and methods We retrospectively reviewed 36 consecutive patients with 37 colorectal tumors who had undergone ESD at Kishiwada Tokushukai Hospital and Naritatomisato Tokushukai Hospital between April 2016 and September 2018. The Nelaton Attachment was used for 22 of the 37 colorectal ESDs. In the ex vivo experiment, endoscopists inserted and withdrew an ESD knife 2 cm using two fingers of their left hand with and without the Nelaton Attachment.

Results Median procedure time was significantly shorter in the Nelaton Attachment group (38 min [range 6 – 195 min]) compared to the non-Nelaton Attachment group (75 min [range 17 – 198 min]; P = 0.030). Median time to complete the ex vivo experiment five times was significantly faster with the Nelaton Attachment than without the Nelaton Attachment (P = 0.001).

Conclusions Use of the Nelaton Attachment for colorectal ESD is feasible and safe, and may facilitate colorectal ESD procedures.