Endoscopic submucosal dissection using a new scissors-type electrosurgical knife: a first-in-human feasibility study

 

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Background and study aims: Endoscopic submucosal dissection (ESD) is more difficult and has a higher rate of complications, such as perforation and bleeding, compared with conventional endoscopic resection. The aim of this study was to evaluate the feasibility of a new scissors-type electrosurgical knife for ESD, which was developed for improved durability and ease of use.

Materials and methods: Initial ex vivo experiments and subsequent ESD procedures in live pigs were carried out. A human feasibility study was then performed in patients with early esophageal or gastric cancer. The primary end point was serious adverse events (SAE) related to ESD.

Results: In the ex vivo and live animal models, no mechanical errors occurred and only minor damage to surrounding tissue was observed. Four patients were enrolled in the human feasibility study; all ESD procedures were completed with a mean procedure time of 31 minutes. All specimens were resected completely without any SAEs. The device worked smoothly, with no electrical problems noted.

Conclusion: ESD using a novel scissors-type knife for early esophageal or gastric cancer is feasible.

Clinical trial registration: UMIN000004941.

• References

• 1 Ono H, Kondo H, Gotoda T et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut 2001; 48: 225-229
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 2 Oyama T, Tomori A, Hotta K et al. Endoscopic submucosal dissection of early esophageal cancer. Clin Gastroenterol Hepatol 2005; 3: 67-70
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 3 Oka S, Tanaka S, Kaneko I et al. Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc 2006; 64: 877-883
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 4 Oda I, Saito D, Tada M et al. A multicenter retrospective study of endoscopic resection for early gastric cancer. Gastric Cancer 2006; 9: 262-270
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 5 Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 2006; 41: 929-942
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 6 The Japan Esophageal Society. Guideline for the clinical and pathologic studies on carcinoma of the esophagus. 10th. edn. Tokyo: Kanehara Syuppan; 2007
  MissingFormLabel

  Search in Google Scholar
• 7 Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 13th. edn. Tokyo: Kanehara & Co; 1999
  MissingFormLabel

  Search in Google Scholar
• 8 Ono H, Hasuike N, Inui T et al. Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer 2008; 11: 47-52
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 9 Akahoshi K, Akahane H, Murata A et al. Endoscopic submucosal dissection using a novel grasping type scissors forceps. Endoscopy 2007; 39: 1103-1105
  MissingFormLabel

  Thieme ConnectPubMedSearch in Google Scholar
• 10 Akahoshi K, Honda K, Akahane H et al. Endoscopic submucosal dissection by using a grasping-type scissors forceps: a preliminary clinical study (with video). Gastrointest Endosc 2008; 67: 1128-1133
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 11 Homma K, Otaki Y, Sugawara M et al. Efficacy of novel SB knife Jr examined in a multicenter study on colorectal endoscopic submucosal dissection. Dig Endosc 2012; 24 (Suppl. 01) 117-120
  MissingFormLabel

  PubMedSearch in Google Scholar