Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial

Takuya Yamada, Masashi Hirota, Shusaku Tsutsui, Motohiko Kato, Tsuyoshi Takahashi, Kazuhiro Yasuda, Kazuki Sumiyama, Masahiko Tsujii, Tetsuo Takehara, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Steady pressure automatically controlled endoscopy (SPACE) is a new modality that eliminates on-demand insufflation but enables automatic insufflation in the gastrointestinal tract. Though its use in porcine esophageal ESD was reported to be promising, its applicability and potential effectiveness to gastric procedures have not been evaluated. Objective: The aims were (1) to evaluate feasibility and safety of SPACE in the stomach, and (2) to assess its potential advantages over conventional endoscopy in preventing “blind insufflation”-related complications. Design: A multicenter randomized preclinical animal study. Setting: Laboratories at three universities. Interventions: Experiment 1: Gastric ESD was attempted in the swine (n = 17), under either SPACE or manual insufflation. Experiment 2: Gastroscopy was performed for 10 min in the perforated stomach (n = 10) under either SPACE or manual insufflation. Main outcome measurements: Experiment 1: ESD time, energy device activation time, number of forceps exchanges, specimen size, en block resection rate, vital signs and any intraoperative adverse events. Experiment 2: Intra-gastric and intra-abdominal pressures, vital signs, and any adverse events. Results: Experiment 1: Gastric ESD was completed in all animals. ESD time tended to be shorter in SPACE than in the control, though the difference was not significant (p = 0.18). Experiment 2: Although both intra-gastric and intra-abdominal pressures remained within preset values in SPACE, they showed excessive elevation in control. Limitations: An animal study with small sample size. Conclusions: SPACE is feasible and safe for complicated and lengthy procedures such as gastric ESD, and is potentially effective in preventing serious consequences related to excessive blind insufflation.

Original languageEnglish
Pages (from-to)2748-2755
Number of pages8
JournalSurgical endoscopy
Volume29
Issue number9
DOIs
Publication statusPublished - Sep 21 2015

Fingerprint

Endoscopy
Stomach
Insufflation
Pressure
Vital Signs
Swine
Endoscopic Mucosal Resection
Gastroscopy
Surgical Instruments
Sample Size
Gastrointestinal Tract
Safety
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial. / Yamada, Takuya; Hirota, Masashi; Tsutsui, Shusaku; Kato, Motohiko; Takahashi, Tsuyoshi; Yasuda, Kazuhiro; Sumiyama, Kazuki; Tsujii, Masahiko; Takehara, Tetsuo; Mori, Masaki; Doki, Yuichiro; Nakajima, Kiyokazu.

In: Surgical endoscopy, Vol. 29, No. 9, 21.09.2015, p. 2748-2755.

Research output: Contribution to journalArticle

Yamada, T, Hirota, M, Tsutsui, S, Kato, M, Takahashi, T, Yasuda, K, Sumiyama, K, Tsujii, M, Takehara, T, Mori, M, Doki, Y & Nakajima, K 2015, 'Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial', Surgical endoscopy, vol. 29, no. 9, pp. 2748-2755. https://doi.org/10.1007/s00464-014-4001-0
Yamada, Takuya ; Hirota, Masashi ; Tsutsui, Shusaku ; Kato, Motohiko ; Takahashi, Tsuyoshi ; Yasuda, Kazuhiro ; Sumiyama, Kazuki ; Tsujii, Masahiko ; Takehara, Tetsuo ; Mori, Masaki ; Doki, Yuichiro ; Nakajima, Kiyokazu. / Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial. In: Surgical endoscopy. 2015 ; Vol. 29, No. 9. pp. 2748-2755.
@article{938f3297c1164a4ebd5d8ed68275c079,
title = "Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial",
abstract = "Background: Steady pressure automatically controlled endoscopy (SPACE) is a new modality that eliminates on-demand insufflation but enables automatic insufflation in the gastrointestinal tract. Though its use in porcine esophageal ESD was reported to be promising, its applicability and potential effectiveness to gastric procedures have not been evaluated. Objective: The aims were (1) to evaluate feasibility and safety of SPACE in the stomach, and (2) to assess its potential advantages over conventional endoscopy in preventing “blind insufflation”-related complications. Design: A multicenter randomized preclinical animal study. Setting: Laboratories at three universities. Interventions: Experiment 1: Gastric ESD was attempted in the swine (n = 17), under either SPACE or manual insufflation. Experiment 2: Gastroscopy was performed for 10 min in the perforated stomach (n = 10) under either SPACE or manual insufflation. Main outcome measurements: Experiment 1: ESD time, energy device activation time, number of forceps exchanges, specimen size, en block resection rate, vital signs and any intraoperative adverse events. Experiment 2: Intra-gastric and intra-abdominal pressures, vital signs, and any adverse events. Results: Experiment 1: Gastric ESD was completed in all animals. ESD time tended to be shorter in SPACE than in the control, though the difference was not significant (p = 0.18). Experiment 2: Although both intra-gastric and intra-abdominal pressures remained within preset values in SPACE, they showed excessive elevation in control. Limitations: An animal study with small sample size. Conclusions: SPACE is feasible and safe for complicated and lengthy procedures such as gastric ESD, and is potentially effective in preventing serious consequences related to excessive blind insufflation.",
author = "Takuya Yamada and Masashi Hirota and Shusaku Tsutsui and Motohiko Kato and Tsuyoshi Takahashi and Kazuhiro Yasuda and Kazuki Sumiyama and Masahiko Tsujii and Tetsuo Takehara and Masaki Mori and Yuichiro Doki and Kiyokazu Nakajima",
year = "2015",
month = "9",
day = "21",
doi = "10.1007/s00464-014-4001-0",
language = "English",
volume = "29",
pages = "2748--2755",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a multicenter randomized preclinical trial

AU - Yamada, Takuya

AU - Hirota, Masashi

AU - Tsutsui, Shusaku

AU - Kato, Motohiko

AU - Takahashi, Tsuyoshi

AU - Yasuda, Kazuhiro

AU - Sumiyama, Kazuki

AU - Tsujii, Masahiko

AU - Takehara, Tetsuo

AU - Mori, Masaki

AU - Doki, Yuichiro

AU - Nakajima, Kiyokazu

PY - 2015/9/21

Y1 - 2015/9/21

N2 - Background: Steady pressure automatically controlled endoscopy (SPACE) is a new modality that eliminates on-demand insufflation but enables automatic insufflation in the gastrointestinal tract. Though its use in porcine esophageal ESD was reported to be promising, its applicability and potential effectiveness to gastric procedures have not been evaluated. Objective: The aims were (1) to evaluate feasibility and safety of SPACE in the stomach, and (2) to assess its potential advantages over conventional endoscopy in preventing “blind insufflation”-related complications. Design: A multicenter randomized preclinical animal study. Setting: Laboratories at three universities. Interventions: Experiment 1: Gastric ESD was attempted in the swine (n = 17), under either SPACE or manual insufflation. Experiment 2: Gastroscopy was performed for 10 min in the perforated stomach (n = 10) under either SPACE or manual insufflation. Main outcome measurements: Experiment 1: ESD time, energy device activation time, number of forceps exchanges, specimen size, en block resection rate, vital signs and any intraoperative adverse events. Experiment 2: Intra-gastric and intra-abdominal pressures, vital signs, and any adverse events. Results: Experiment 1: Gastric ESD was completed in all animals. ESD time tended to be shorter in SPACE than in the control, though the difference was not significant (p = 0.18). Experiment 2: Although both intra-gastric and intra-abdominal pressures remained within preset values in SPACE, they showed excessive elevation in control. Limitations: An animal study with small sample size. Conclusions: SPACE is feasible and safe for complicated and lengthy procedures such as gastric ESD, and is potentially effective in preventing serious consequences related to excessive blind insufflation.

AB - Background: Steady pressure automatically controlled endoscopy (SPACE) is a new modality that eliminates on-demand insufflation but enables automatic insufflation in the gastrointestinal tract. Though its use in porcine esophageal ESD was reported to be promising, its applicability and potential effectiveness to gastric procedures have not been evaluated. Objective: The aims were (1) to evaluate feasibility and safety of SPACE in the stomach, and (2) to assess its potential advantages over conventional endoscopy in preventing “blind insufflation”-related complications. Design: A multicenter randomized preclinical animal study. Setting: Laboratories at three universities. Interventions: Experiment 1: Gastric ESD was attempted in the swine (n = 17), under either SPACE or manual insufflation. Experiment 2: Gastroscopy was performed for 10 min in the perforated stomach (n = 10) under either SPACE or manual insufflation. Main outcome measurements: Experiment 1: ESD time, energy device activation time, number of forceps exchanges, specimen size, en block resection rate, vital signs and any intraoperative adverse events. Experiment 2: Intra-gastric and intra-abdominal pressures, vital signs, and any adverse events. Results: Experiment 1: Gastric ESD was completed in all animals. ESD time tended to be shorter in SPACE than in the control, though the difference was not significant (p = 0.18). Experiment 2: Although both intra-gastric and intra-abdominal pressures remained within preset values in SPACE, they showed excessive elevation in control. Limitations: An animal study with small sample size. Conclusions: SPACE is feasible and safe for complicated and lengthy procedures such as gastric ESD, and is potentially effective in preventing serious consequences related to excessive blind insufflation.

UR - http://www.scopus.com/inward/record.url?scp=84939557070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939557070&partnerID=8YFLogxK

U2 - 10.1007/s00464-014-4001-0

DO - 10.1007/s00464-014-4001-0

M3 - Article

C2 - 25480619

AN - SCOPUS:84939557070

VL - 29

SP - 2748

EP - 2755

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 9

ER -