Endoscopy 2014; 46(06): 499-502
DOI: 10.1055/s-0034-1364879
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel endoscopic submucosal dissection technique with robust and adjustable tissue traction

Masashi Hirota*
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
2  Division of Collaborative Research for Next Generation Endoscopic Intervention (Project ENGINE), The Center for Advanced Medical Engineering and Informatics, Osaka University, Osaka, Japan
,
Motohiko Kato*
3  Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
,
Makoto Yamasaki
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
,
Naoki Kawai
4  Department of Gastroenterology, Osaka Police Hospital, Osaka, Japan
,
Yasuhiro Miyazaki
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
,
Takuya Yamada
3  Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
,
Tsuyoshi Takahashi
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
,
Tetsuo Takehara
3  Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan
,
Masaki Mori
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
,
Yuichiro Doki
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
,
Kiyokazu Nakajima
1  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
2  Division of Collaborative Research for Next Generation Endoscopic Intervention (Project ENGINE), The Center for Advanced Medical Engineering and Informatics, Osaka University, Osaka, Japan
› Author Affiliations
Further Information

Publication History

submitted 08 July 2013

accepted after revision 12 July 2013

Publication Date:
28 January 2014 (eFirst)

Background and study aims: A novel esophageal endoscopic submucosal dissection (ESD) technique was devised using a newly developed overtube to achieve adequate tissue traction. The aim of this study was to evaluate the feasibility and safety of this new full-traction ESD (tESD) technique.

Methods: The key feature of tESD is tissue traction by grasping forceps, which is passed through the built-in side channel of the overtube. The strength and direction of traction is controlled by rotating the overtube and by adjusting its depth. The en bloc resection rate, procedure time, adverse events, and dissected area per minute were evaluated in a porcine model (n = 10) and compared with those of conventional ESD (n = 10).

Results: tESD provided robust and adjustable tissue traction during the procedure. En bloc resection was accomplished in all lesions with no complications. Median procedure time was similar to that of the conventional technique (25 vs. 27 minutes; P = 0.4723) but the submucosal injection catheter was used less often (1.5 vs. 6; P < 0.01).

Conclusions: tESD might contribute to more efficient esophageal ESD by providing adequate tissue traction. This inexpensive technique may become an attractive option in esophageal ESD.

* These authors contributed equally to this work.