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DOI: 10.1055/a-2048-6170
Use of unique endoscope holder and scissor-style knife reduces difficulty of endoscopic submucosal dissection
Authors
The stability of the endoscope tip is very important in endoscopic submucosal dissection (ESD). Especially in the case of a scissors-type incision device, it is important to be able to insert and remove the device while maintaining the field of view. This study examined gastric ESD using an endoscope holder, the Endo KEYper (Boston Scientific, Marlborough, Massachusetts, USA) ([Fig. 1], [Fig. 2]), and a scissors-type incision device, the SB Knife (SB-Kawasumi Laboratories, Inc., Kanagawa, Japan).
The Endo KEYper is a device that is fixed to the overtube (top) to prevent the endoscope from falling out, and the endoscope remains stable even when the right hand is removed from the shaft, allowing the device to be inserted and removed with the right hand ([Fig. 3]). The SB Knife was used in nine gastric ESD cases, divided into those with and without the Endo KEYper and those with and without traction [1].
The number of SB Knife detachments per endoscope hold was 1.3 in the three cases without the Endo KEYper, 2.2 in the three cases with the Endo KEYper, and 4.8 in the three cases with the Endo KEYper plus traction. The use of the Endo KEYper enabled continuous dissection by inserting and removing the SB Knife because the endoscope remained in place even when the right hand was released. Furthermore, the traction of the Endo KEYper allowed the dissected surface to expand without the use of a hood, enabling further continuous dissection ([Video 1]).
Video 1 Examination of using the Endo KEYper and SB Knife in gastric endoscopic submucosal dissection.
The combination of the Endo KEYper and SB Knife was useful, and the combination with traction was able to reduce the difficulty of ESD.
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Publication History
Article published online:
23 March 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Reference
- 1 Fukami N. What we want for ESD is a second hand! Traction method. Gastrointest Endosc 2013; 78: 274-276