Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study

Ryu Nakadate; Shotaro Nakamura; Tomohiko Moriyama; Hajime Kenmotsu; Susumu Oguri; Jumpei Arata; Munenori Uemura; Kenoki Ohuchida; Tomohiko Akahoshi; Tetsuo Ikeda; Makoto Hashizume

doi:10.1055/s-0034-1391438

Endoscopy, Inhaltsverzeichnis

Endoscopy 2015; 47(09): 820-824
DOI: 10.1055/s-0034-1391438

Innovations and brief communications

Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study

Ryu Nakadate

¹Department of Research and Development for Surgical Support Systems, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan

,

Shotaro Nakamura

¹Department of Research and Development for Surgical Support Systems, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan

²Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Tomohiko Moriyama

²Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Hajime Kenmotsu

¹Department of Research and Development for Surgical Support Systems, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan

,

Susumu Oguri

³Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Jumpei Arata

¹Department of Research and Development for Surgical Support Systems, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan

,

Munenori Uemura

³Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Kenoki Ohuchida

⁴Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Tomohiko Akahoshi

³Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Tetsuo Ikeda

³Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

,

Makoto Hashizume

¹Department of Research and Development for Surgical Support Systems, Center for Advanced Medical Innovation, Kyushu University, Fukuoka, Japan

³Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

› Institutsangaben

Abstract

Background and study aims: The conventional procedure of endoscopic submucosal dissection (ESD) is technically demanding. This study investigated the efficiency of novel articulating devices (maximum diameter 2.6 mm), which can be used with commercially available, standard endoscopes.

Patients and methods: In an ex vivo comparative study, eight endoscopists were divided into novices and experienced operators, and performed ESD using new devices and the conventional setup. An in vivo animal experiment was performed by two experts. Procedure times for incision and dissection were recorded, and unit times for circumferential length and area of specimens were calculated.

Results: All procedures were successfully completed with en bloc resection. In the ex vivo study, the unit procedure times for incision and dissection by novices were significantly shorter using the new system (P < 0.01 and P < 0.05), whereas there was no significant difference for experienced endoscopists. Perforation occurred during one procedure in which the new system was used. The in vivo experiments were successfully completed without adverse events.

Conclusions: ESD using novel articulating devices was feasible. These devices were able to reduce the procedure time for novices.

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Referenzen

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