Comparison of conventional versus Hybrid knife peroral endoscopic myotomy methods for esophageal achalasia: a case–control study

Tang, Xiaowei; Gong, Wei; Deng, Zhao‐Peng; Zhou, Jieqiong; Ren, Yun; Zhang, Qiang; Chen, Zhenyu; Jiang, Bo

doi:10.3109/00365521.2015.1059878

Cited by 31 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are two possible reasons for the short procedural time: one is the high-pressure water jet, which made the submucosal injection easier than that using a conventional injection needle; the other is the ability to perform a submucosal injection and incision with one tool, which saves time in switching between the injection needle and electrosurgical knife. Tang et al [12] revealed that the use of an HK in peroral endoscopic myotomy can shorten the procedural time compared to the conventional method (injection needle and triangular tip knife), which supports our hypothesis. The biopsy size using an HK is obviously larger than that using SFF, and in cases 1 and 3, SFF was not able to collect appropriately sized biopsies.…”

Section: Discussionsupporting

confidence: 80%

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Yin

Eberhardt²,

Wang³

et al. 2016

Respiration

View full text Add to dashboard Cite

Semi-rigid thoracoscopy is an important technique in the definitive diagnosis of pleural diseases with high diagnostic sensitivity and specificity. Obtaining adequate samples from thickened pleura is the most important limitation of semi-rigid thoracoscopy with a standard flexible forceps (SFF) compared with rigid thoracoscopy, especially in patients with mesothelioma or benign fibrothorax. Developing a convenient, efficient and safe biopsy technique to obtain sufficient samples from such patients is a key topic in semi-rigid thoracoscopy. The hybrid knife (HK) is an innovative design fusing high-pressure water injection and a conventional diathermic knife that can allow for the safe resection of a larger lesion during gastrointestinal endoscopic dissection. Here, we describe 3 patients with unexplained pleural effusion who underwent pleural biopsy using an HK to investigate the potential use of the HK as a new pleural biopsy device in semi-rigid thoracoscopy when pleural lesions are difficult to biopsy using an SFF. The biopsies were obtained successfully by HK, and the diagnosis followed. The sizes of the biopsies collected by HK are larger than those collected by SFF. No complications were observed. Electrocautery biopsy using an HK during semi-rigid thoracoscopy has great potential for diagnosing consistent abnormal pleuras, which are difficult to biopsy with an SFF.

show abstract

Section: Discussionsupporting

confidence: 80%

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Yin

Eberhardt²,

Wang³

et al. 2016

Respiration

View full text Add to dashboard Cite

show abstract

“…Although the use of several kinds of electrosurgical knives in POEM has been reported 3 13 14 , the best device has yet to be determined, with the choice of knife often depending on the endoscopist’s experience, expertise, and preference. According to previous reports, the triangle tip knife (KD-640L; Olympus Medical Systems, Japan) is most commonly used for POEM, and the HybridKnife (Erbe Elektromedizin GmbH, Tübingen, Germany), which has waterjet function, is also widely used 3 12 .…”

Section: Introductionmentioning

confidence: 99%

Peroral endoscopic myotomy using FlushKnife BT: a single-center series

et al. 2017

View full text Add to dashboard Cite

Background and study aims Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM. Patients and methods A total of 54 consecutive patients with achalasia and other spastic esophageal motility disorders, such as jackhammer esophagus or distal esophageal spasm, who underwent POEM between January 2016 and August 2016, were included in this retrospective study. Results The median operation time was 73.0 minutes (range 39 – 184 minutes). All procedures were completed using only the FlushKnife BT without changing to any other electrosurgical instrument. The median number of additional submucosal injections with an injection needle was 0 (range 0 – 1). Endoscopic vessel sealing was performed a mean of 3 times (range 0 – 7). The median number of bleeding episodes requiring treatment with hemostatic forceps was 0 (range 0 – 5). There were no significant adverse events. Seven of 52 patients (13.5 %) reported symptoms of gastroesophageal reflux disease such as heartburn or acid reflux at 3 month follow-up. Conclusions The FlushKnife BT enabled POEM to be performed with very few device exchanges, either for re-injection or to control intraoperative bleeding. In this uncontrolled case series, the ability of the FlushKnife BT to perform nearly all aspects of the POEM procedure seems to make it particularly well suited to this procedure.

show abstract

“…A retrospective comparative analysis noted a shorter POEM procedure time with a hybrid knife versus a triangular tip knife (53.0 AE 17.2 vs 67.6 AE 28.4 minutes; P Z .02) but similar clinical outcomes and adverse event rates. 44 A randomized, prospective, controlled trial, comparing the hybrid knife with the water-jet system and the triangular tip knife with the conventional injection technique, reported significantly decreased procedure times with the hybrid knife (22.9 AE 6.7 vs 35.9 AE 11.7 minutes; P < .01), with no differences in clinical outcomes or adverse event rates. 19…”

Section: Comparative Studies On Technique Variationsmentioning

confidence: 99%

Per-oral endoscopic myotomy (with video)

Pannala¹,

Dayyeh²,

Aslanian³

et al. 2016

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

Comparison of conventional versus Hybrid knife peroral endoscopic myotomy methods for esophageal achalasia: a case–control study

Abstract: HK in POEM can shorten the procedural time, and achieve similar treatment success compared to conventional TT knife.

Cited by 31 publications

References 28 publications

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Semi-Rigid Thoracoscopic Punch Biopsy Using a Hybrid Knife with a High-Pressure Water Jet for the Diagnosis of Pleural Effusions

Peroral endoscopic myotomy using FlushKnife BT: a single-center series

Per-oral endoscopic myotomy (with video)

Contact Info

Product

Resources

About