Endoscopy 2019; 51(04): S12
DOI: 10.1055/s-0039-1681203
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Colon ESD South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC SUBMUCOSAL DISSECTION OF RECTAL SUPERFICIAL TUMORS WITH A NEW ENDOSCOPIC PLATFORM: THE ORISE TISSUE RETRACTOR SYSTEM. A MULTICENTER EUROPEAN SERIES

R Maselli
1   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
,
PA Galtieri
1   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
,
PJ Belletrutti
1   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
,
F D'Amico
1   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
,
L Varytimiadis
2   Gastroenterology Department, University of Portsmouth, Portsmouth, United Kingdom
,
EA Albizu
3   Gastroenterology Department, Complejo Hospitalario de Navarra, Navarra, Spain
,
A Repici
1   Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
4   Humanitas University, Milan, Italy
5   Department of Biomedical Science, Humanitas University, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Endoscopic submucosal dissection (ESD) is accepted worldwide for resection of most superficial tumors > 20 mm in the GI. The main challenges of ESD are related to the instability of the operative field and the lack of tissue traction. The ORISE Tissue Retractor System (TRS, Boston Scientific) is a new endoscopic platform designed to overcome these limitations. Aim of this study is to assess the efficacy and safety of the TRS used in the first human procedures in three different European centers.

Methods:

The TRS consists of an expandable intra-luminal chamber mounted on a flexible overtube with two grasping retractors. It is front-loaded over the endoscope and inserted into the rectum. The cage is then opened to create a stable operating field around the lesion. The submucosal dissection is simplified by two grasping retractors in order to provide traction and improve visualization of planes. Data on lesion characteristics, procedure details and adverse events were collected and analyzed.

Results:

Data are available on the first 10 cases of rectal ESD (5 males/4 females, mean age 67 ± 9 years). The mean size of the lesions was 56.7 ± 25.1 mm (range 25 – 100 mm). The TRS and graspers were easily placed in all cases; mean procedure time was 107.11 ± 31.3 minutes. All lesions were removed en-bloc with an R0 resection. The final histological assessment was LGD in 1 case, HGD in 7 and adenocarcinoma in 2. All but one were curative resections. No adverse events were recorded, except 1 case of self-limited fever during the first 24 hours.

Conclusions:

The ORISETRS both stabilizes the operative field and allows for tissue retraction, thus improving visualization of the dissection plane, potentially increasing the efficiency of the ESD and reducing the risk of adverse events. Although prospective studies are needed, this initial human experience shows the TRS be a promising tool for the treatment of colorectal neoplastic lesions.