FEASIBILITY AND SAFETY OF A NOVEL OVER-THE-SCOPE DEVICE TO FACILITATE ENDOSCOPIC ARGON PLASMA COAGULATION – AN EX-VIVO STUDY

Aims Argon plasma coagulation (APC) is an electrosurgical procedure used for various indications in the gastrointestinal tract, such as ablation of dysplastic Barrett’s mucosa. Homogeneous and safe application can be compromised by varying distances and suboptimal angle of the probe to the tissue. The Argon Precision Cap is a novel endoscopic device developed to optimize endoluminal APC treatment. Objectives of this study were to assess feasibility and safety and to determine suitable APC settings for tissue ablation in the esophagus.

Methods Feasibility of APC treatment in different locations was assessed in 20 explanted procine esophagi. To assess thermal effect on the tissue, additional 132 ablations of predefined areas using various APC settings were performed in the opened esophagus. Depth of thermal injury was assessed histologically.

Results Ablations in all quadrants of the esophagus were feasible. In the opened esophagus, macroscopically complete and homogeneous ablations of predefined 1.5x1.5 cm areas were performed in a median time of 25 sec (range 7- 87 sec). Histologically, thermal effects involving the whole thickness of the mucosa were visible with all settings. APC with Pulsed mode resulted in deep thermal damage with all power settings. No lesions of the muscular layer occurred using Precise (E8,9) and Forced (10, 20 W) mode.

Conclusions Esophageal APC using the novel cap is feasible and safe in an ex-vivo model. The device has the potential to further improve APC treatment of larger mucosal areas. In vivo studies are necessary to further assess efficacy and safety.

Publication History

Article published online:
14 April 2022