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CC BY 4.0 · Endoscopy 2023; 55(S 01): E704-E705
DOI: 10.1055/a-2072-3959
E-Videos

Novel protective retrieval bag for safe removal of gastric gastrointestinal stromal tumor after endoscopic full-thickness resection

Miguel Fraile-López 
1   Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
2   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Noriya Uedo 
2   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Yoji Takeuchi 
2   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Tomoki Michida
2   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
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Endoscopic resection of gastric subepithelial lesions (GSELs) is gaining in popularity owing to its good results and less invasive nature compared to surgery [1] [2]. However, extracting specimens through the gastroesophageal junction or upper esophageal sphincter can be technically challenging and may cause fragmentation or capsule damage, which may lead to an inaccurate histopathological evaluation [2].

Here, we report of a new retrieval device (ENDO CARRY, Hakko Co., Ltd., Nagano, Japan) with a drawstring-type plastic bag [3] that facilitates the safe retrieval of resected GSELs. This device consists of a larger transparent plastic bag (60 mm) that is not pulled into the sheath when it is completely closed, which prevents specimen damage during the extraction ([Fig. 1]). This device cannot be used through the working channel, so for its insertion the transparent bag is placed on the tip of the endoscope, which allows reaching the stomach while seeing through the bag. For specimen retrieval, the bag is opened into the stomach and the GSEL is introduced inside using a grasping forceps or using the latter to directly trap the GSEL with the bag ([Video 1]).

Zoom Image
Fig. 1 Modified ENDO CARRY bag for protective retrieval of gastric subepithelial lesions. a Retrieval device in an open position. b Retrieval device in the closed position with the bag out of the sheath. c Major (80 mm) and minor (60 mm) diameter with complete open position.

Video 1 Protective retrieval bag for safe removal of gastric gastrointestinal stromal tumor after endoscopic full-thickness resection.


Quality:

Our experience consists of nine GSEL retrievals by using this bag. The median GSEL size was 22 × 26 mm [19–25, 23–38]; four (44 %) were grasped with forceps into the bag, and five (56 %) were directly grasped preventing pseudocapsule injury in all of them ([Fig. 2]).

Zoom Image
Fig. 2 Endoscopic full-thickness resection of a gastric gastrointestinal stromal tumor (GIST) with an endoluminal component. a Endoscopic retroflex view with subcardiac/lesser curvature GIST. b Submucosal dissection completed with complete tumor exposure. c Clip-line traction method applied before muscle cut. d Full-thickness resection almost completed. e Defect view after tumor removal. f, g Purse-string suture. h Complete defect closure.

Endoscopy_UCTN_Code_TTT_1AO_2AC

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Competing interests

The authors declare that they have no conflict of interest.

  • References

  • 1 Deprez PH, Moons LMG, OʼToole D. et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54: 412-429
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Shichijo S, Abe N, Takeuchi H. et al. Endoscopic resection for gastric submucosal tumors: Japanese multicenter retrospective study. Dig Endosc 2022; 35: 206-215
    CrossrefPubMedSearch in Google Scholar
  • 3 Inoue T, Shichijo S, Nakajima K. Novel protective retrieval device for a large rectal cancer specimen resected by endoscopic submucosal dissection. Dig Endosc 2021; 33: e129-e130
    PubMedSearch in Google Scholar

Corresponding author

Noriya Uedo, MD
Department of Gastrointestinal Oncology
Osaka International Cancer Institute
3-1-69, Otemae, Chuo-ku
Osaka 541-8567
Japan   
Fax: +81-6-6945-1902   

Publication History

Article published online:
10 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Deprez PH, Moons LMG, OʼToole D. et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54: 412-429
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Shichijo S, Abe N, Takeuchi H. et al. Endoscopic resection for gastric submucosal tumors: Japanese multicenter retrospective study. Dig Endosc 2022; 35: 206-215
    CrossrefPubMedSearch in Google Scholar
  • 3 Inoue T, Shichijo S, Nakajima K. Novel protective retrieval device for a large rectal cancer specimen resected by endoscopic submucosal dissection. Dig Endosc 2021; 33: e129-e130
    PubMedSearch in Google Scholar

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Zoom Image
Fig. 1 Modified ENDO CARRY bag for protective retrieval of gastric subepithelial lesions. a Retrieval device in an open position. b Retrieval device in the closed position with the bag out of the sheath. c Major (80 mm) and minor (60 mm) diameter with complete open position.
Zoom Image
Fig. 2 Endoscopic full-thickness resection of a gastric gastrointestinal stromal tumor (GIST) with an endoluminal component. a Endoscopic retroflex view with subcardiac/lesser curvature GIST. b Submucosal dissection completed with complete tumor exposure. c Clip-line traction method applied before muscle cut. d Full-thickness resection almost completed. e Defect view after tumor removal. f, g Purse-string suture. h Complete defect closure.