Novel three-dimensional imaging system may facilitate gastric endoscopic submucosal dissection procedure: an ex vivo animal study
submitted06 April 2018
accepted after revision04 September 2018
10 December 2018 (online)
Background and study aims Endoscopic submucosal dissection (ESD) requires advanced skills to perform safely without complications. The current study evaluated the usefulness of a novel three-dimensional (3D) imaging system in ESD using porcine stomachs.
Methods Four endoscopists (two trainees and two experts) performed eight ESD procedures using both 3D and 2D images. The usefulness of 3D image versus 2D image was evaluated by visibility and procedure time. In addition, occurrence of eyestrain and dizziness in 3D image was assessed.
Results En bloc resection was successfully achieved, without perforation, in all cases. The evaluation score in the 3D image group was better than that in the 2D image group, particularly depth perception was statistically significantly good. No significant difference was found in the working speed between the 2D and 3D image groups. Two examiners experienced eyestrain and dizziness while using the 3D image.
Conclusions All the ESD procedures were performed safely. Depth perception using the 3D image was better than with the 2D image. A novel 3D image system may facilitate ESD.
- 1 Gotoda T, Yanagisawa A, Sasako M. et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000; 3: 219-225
- 2 Hirasawa T, Gotoda T, Miyata S. et al. Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer 2009; 12: 148-152
- 3 Ohkuwa M, Hosokawa K, Boku N. et al. New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy 2001; 33: 221-226
- 4 Shiro O, Shinji T, Iwao K. et al. Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastroenterol Endosc 2006; 64: 877-883
- 5 Becker H, Melzer A, Schurr MO. et al. 3-D video techniques in endoscopic surgery. Endosc Surg Allied Technol 1993; 1: 40-46
- 6 Fergo C, Burcharth J, Pommergaard HC. et al. Three-dimensional laparoscopy vs 2-dimensional laparoscopy with high-definition technology for abdominal surgery: a systematic review. Am J Surg 2017; 213: 159-170
- 7 Odagiri H, Yasunaga H. Complications following endoscopic submucosal dissection for gastric, esophageal, and colorectal cancer: a review of studies based on nationwide large-scale databases. Ann Transl Med 2017; 5: 189
- 8 Matsumura T, Ishigami H, Okimoto K. et al. Three-dimensional imaging system for colonoscopy. Endoscopy 2017; 49: 716-717
- 9 Soichiro Y, Kazunori K, Tsuneo F. et al. Novel three-dimensional image system for transurethral surgery. Int J Urol 2015; 22: 714-715
- 10 Stine S, Mona S, Lars K. et al. Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 2016; 30: 11-23
- 11 Melina CV, Liane SF, Christopher GA. et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 2005; 190: 107-113
- 12 Kikuchi D, Kaise M, Nomura K. et al. Feasibility study of the three-dimensional flexible endoscope in endoscopic submucosal dissection: an ex vivo animal study. Digestion 2017; 95: 237-241
- 13 Sun CC, Chiu AW, Chen KK. et al. Assessment of a three-dimensional operating system with skill tests in a pelvic trainer. Urol Int 2000; 64: 154-158
- 14 Sørensen SM, Savran MM, Konge L. et al. Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 2016; 30: 11-23
- 15 Deprez PH, Bergman JJ, Meisner S. et al. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts. Endoscopy 2010; 42: 853-858
- 16 Ebigbo A, Messmann H. How can we make the learning curve of endoscopic submucosal dissection for (Western) endoscopists less steep?. Endoscopy 2016; 48: 697-698
- 17 Bhatt A, Abe S, Kumaravel A. et al. Video-based supervision for training of endoscopic submucosal dissection. Endoscopy 2016; 48: 711-716