Efficacy of traction, using a clip-with-thread, for esophageal endoscopic submucosal dissection for esophageal lesions with fibrosis in an ex vivo pig training model

Esaki, Mitsuru; Minoda, Yosuke; Ihara, Eikichi; Sakisaka, Seiichiro; Tsuruta, Satoshi; Hosokawa, Toshinori; Wada, Masafumi; Hata, Yoshitaka; Suzuki, Shinichi; Iwao, Aya; Yamakawa, Shun; Irie, Atsushi; Akiho, Hirotada; Ogawa, Yoshihiro

doi:10.5152/tjg.2020.19207

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…In the previous study, target lesions like pseudopolyps or depressed mucosal defects without submucosal fibrosis were considered as training models [ 20 , 31 ]. Esaki M et al [ 32 ] proposed an artificial esophagus model with fibrosis created at the center of the mock lesion by thread suturing and proved that it could be used to evaluate the usefulness of clip-with-thread traction for difficult ESD. However, the artificial fibrosis model was short on blood supply compared with the simulated lesions we developed, which could not evaluate the influence of bleeding during ESD performance.…”

Section: Discussionmentioning

confidence: 99%

Novel beagle model of gastric local fibrotic target lesions for the evaluation and training of endoscopic techniques

He,

Wang,

Jiang

et al. 2023

BMC Gastroenterol

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Background Novel endoscopic techniques used in the treatment of gastric lesions with local submucosal fibrosis need preclinical evaluation and training due to safety limitations. Therefore, the purpose of our study was to establish an animal model of gastric local fibrotic target lesions and assess its feasibility in the evaluation and training of endoscopic techniques. Methods In six experimental beagles, a 50% glucose solution was injected into three submucosal areas of the fundus, body, and antrum of the stomach to create gastric local fibrotic target lesions (experimental group). On post-injection day (PID) 7, the injection sites were assessed endoscopically to confirm the presence of submucosal fibrosis formation, and the dental floss clip traction assisted endoscopic submucosal dissection (DFC-ESD) procedure was performed on the gastric local fibrotic target lesions to confirm its feasibility after endoscopic observation. The normal gastric mucosa of six control beagles underwent the same procedure (control group). All the resected specimens were evaluated by histological examination. Results All 12 beagles survived without postoperative adverse events. On PID 7, 16 ulcer changes were observed at the injection sites (16/18) under the endoscope, and endoscopic ultrasonography confirmed the local submucosal fibrosis formation in all ulcer lesions. The subsequent DFC-ESD was successfully performed on the 32 gastric target lesions, and the mean submucosal dissection time in the ulcer lesions was greater than that in the normal gastric mucosa (15.3 ± 5.6 vs. 6.8 ± 0.8 min; P < 0.001). There was no difference in rates of en bloc resection, severe hemorrhage, or perforation between the two groups. Histological analysis of the ulcer lesions showed the absence of epithelial or muscularis mucosae and extensive submucosal fibrous tissue proliferations compared with normal gastric mucosa. Overall, endoscopists had high satisfaction with the realism and feasibility of the animal model. Conclusion We developed a novel animal model of gastric local fibrotic target lesions to simulate difficult clinical situations, which strongly appeared to be suitable for the preclinical evaluation and learning of advanced endoscopic techniques.

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Section: Discussionmentioning

confidence: 99%

Novel beagle model of gastric local fibrotic target lesions for the evaluation and training of endoscopic techniques

He,

Wang,

Jiang

et al. 2023

BMC Gastroenterol

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“…We believe that the improved outcomes observed with RBC-ERBT can be attributed to the traction provided by the second rotatable channel. In the gastrointestinal field, various traction devices have been used in endoscopic submucosal dissection and shown to facilitate the surgery [26][27][28][29][30]. However, the urethra, a long, narrow, and tubular structure, poses challenges in placing traction devices into the bladder.…”

Section: Discussionmentioning

confidence: 99%

Rotatable Bi-Channel En Bloc Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer in an Ex Vivo Porcine Model

Yao,

Jiang,

Niu

et al. 2023

Cancers

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En bloc resection of bladder tumor (ERBT) is a promising alternative for non-muscle-invasive bladder cancer management. However, the tumor characteristics and surgeon’s experience influence its application. Therefore, in this pilot study, we developed a technique called “rotatable bi-channel en bloc resection of bladder tumor (RBC-ERBT)” and assessed its feasibility, efficacy, and safety compared with those of conventional ERBT. In an ex vivo porcine bladder model, 160 bladder lesions of varying morphologies (exophytic and flat) and sizes (1 and 2 cm) were created and evenly distributed across different locations. A total of 160 procedures were performed, with the ERBT and RBC-ERBT group each exhibiting 80 lesions. RBC-ERBT had a significantly higher technical success rate than ERBT (98.8% vs. 77.5%) for exophytic and flat lesions of both sizes and dome lesions. The procedure time was significantly shorter in the RBC-ERBT group, particularly for flat lesions, lesions with a 2 cm diameter, and lesions located at the dome. RBC-ERBT had a significantly lower piecemeal resection rate than ERBT (0% vs. 18.8%). The incidence of perforation or detrusor muscle sampling did not differ between the groups. Compared with conventional ERBT, RBC-ERBT offered improved success rates, reduced resection times, and effective management of challenging lesions.

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“…However, it is not always feasible. Various assistive methods have been invented to overcome the difficulties encountered 2–4 . We present a case of successful traction‐assisted ESD using a novel clip‐band traction device, SureClip traction band (Micro‐tech, Nanjing, China).…”

Section: Brief Explanationmentioning

confidence: 99%

Traction‐assisted endoscopic submucosal dissection for esophageal neoplasms using a novel traction device

Ogura

Ichijima

Ikehara

2022

Digestive Endoscopy

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Efficacy of traction, using a clip-with-thread, for esophageal endoscopic submucosal dissection for esophageal lesions with fibrosis in an ex vivo pig training model

Abstract: Stem cells for pancreatitis 425 Gastric injury and bacterial overgrowth 433 The effect of visceral fat on SMA configuration 451 Antiplatelet agents in ulcerative colitis 459 Differentiation of BMSCs into intestinal ce 466 GERDOFF ® efficacy in patients with GERD

Cited by 4 publications

References 26 publications

Novel beagle model of gastric local fibrotic target lesions for the evaluation and training of endoscopic techniques

Novel beagle model of gastric local fibrotic target lesions for the evaluation and training of endoscopic techniques

Rotatable Bi-Channel En Bloc Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer in an Ex Vivo Porcine Model

Traction‐assisted endoscopic submucosal dissection for esophageal neoplasms using a novel traction device

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