Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study

Mitsuru Esaki, Yosuke Minoda, Masafumi Wada, Seiichiro Sakisaka, Shinichi Tsuruta, Taizo Hosokawa, Takahiro Matsuguchi, Ryoji Ichijima, Sho Suzuki, Yu Tamura, Aya Iwao, Shun Yamakawa, Akira Irie, Eikichi Ihara, Yoshihiro Ogawa

研究成果: ジャーナルへの寄稿記事

抄録

Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399-619.3) s (median incision time: 240.4 [168.3-332.5] s; median dissection time: 222 [182.8-257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9-14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.

元の言語英語
ジャーナルDigestion
DOI
出版物ステータス受理済み/印刷中 - 1 1 2019

Fingerprint

Swine
Equipment and Supplies
Endoscopic Mucosal Resection
Sus scrofa
Injections
Esophagus
Gastrointestinal Tract
Dissection
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Gastroenterology

これを引用

Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance : An ex vivo Porcine Model Study. / Esaki, Mitsuru; Minoda, Yosuke; Wada, Masafumi; Sakisaka, Seiichiro; Tsuruta, Shinichi; Hosokawa, Taizo; Matsuguchi, Takahiro; Ichijima, Ryoji; Suzuki, Sho; Tamura, Yu; Iwao, Aya; Yamakawa, Shun; Irie, Akira; Ihara, Eikichi; Ogawa, Yoshihiro.

:: Digestion, 01.01.2019.

研究成果: ジャーナルへの寄稿記事

Esaki, M, Minoda, Y, Wada, M, Sakisaka, S, Tsuruta, S, Hosokawa, T, Matsuguchi, T, Ichijima, R, Suzuki, S, Tamura, Y, Iwao, A, Yamakawa, S, Irie, A, Ihara, E & Ogawa, Y 2019, 'Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study', Digestion. https://doi.org/10.1159/000502771
Esaki, Mitsuru ; Minoda, Yosuke ; Wada, Masafumi ; Sakisaka, Seiichiro ; Tsuruta, Shinichi ; Hosokawa, Taizo ; Matsuguchi, Takahiro ; Ichijima, Ryoji ; Suzuki, Sho ; Tamura, Yu ; Iwao, Aya ; Yamakawa, Shun ; Irie, Akira ; Ihara, Eikichi ; Ogawa, Yoshihiro. / Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance : An ex vivo Porcine Model Study. :: Digestion. 2019.
@article{8664d873f7184bd9bdf6b4575f7d5d86,
title = "Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study",
abstract = "Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399-619.3) s (median incision time: 240.4 [168.3-332.5] s; median dissection time: 222 [182.8-257] s). En bloc resection rate was 100{\%}. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9-14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100{\%} en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.",
author = "Mitsuru Esaki and Yosuke Minoda and Masafumi Wada and Seiichiro Sakisaka and Shinichi Tsuruta and Taizo Hosokawa and Takahiro Matsuguchi and Ryoji Ichijima and Sho Suzuki and Yu Tamura and Aya Iwao and Shun Yamakawa and Akira Irie and Eikichi Ihara and Yoshihiro Ogawa",
year = "2019",
month = "1",
day = "1",
doi = "10.1159/000502771",
language = "English",
journal = "Digestion",
issn = "0012-2823",
publisher = "S. Karger AG",

}

TY - JOUR

T1 - Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance

T2 - An ex vivo Porcine Model Study

AU - Esaki, Mitsuru

AU - Minoda, Yosuke

AU - Wada, Masafumi

AU - Sakisaka, Seiichiro

AU - Tsuruta, Shinichi

AU - Hosokawa, Taizo

AU - Matsuguchi, Takahiro

AU - Ichijima, Ryoji

AU - Suzuki, Sho

AU - Tamura, Yu

AU - Iwao, Aya

AU - Yamakawa, Shun

AU - Irie, Akira

AU - Ihara, Eikichi

AU - Ogawa, Yoshihiro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399-619.3) s (median incision time: 240.4 [168.3-332.5] s; median dissection time: 222 [182.8-257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9-14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.

AB - Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399-619.3) s (median incision time: 240.4 [168.3-332.5] s; median dissection time: 222 [182.8-257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9-14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.

UR - http://www.scopus.com/inward/record.url?scp=85072911365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072911365&partnerID=8YFLogxK

U2 - 10.1159/000502771

DO - 10.1159/000502771

M3 - Article

C2 - 31563900

AN - SCOPUS:85072911365

JO - Digestion

JF - Digestion

SN - 0012-2823

ER -