Feasibility of a Newly Developed Thumb Control Device for Simultaneous Manipulation of the Endoscope and Treatment Devices in Endoscopic Submucosal Dissection: A Clinical Feasibility Study

Kikuchi, Daisuke; Iizuka, Toshiro; Yamada, Akihiro; Nomura, Kosuke; Kuribayashi, Yasutaka; Kimura, Ryusuke; Hoteya, Shu; Kaise, Mitsuru

doi:10.1159/000450703

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…The time spent to achieve haemostasis and the poor visibility of the bleeding point during the process impose added psychological stress on the endoscopist and may also increase the risk of perforation 4–6. Recent developments and improvements in endoscopic devices and the ESD technique have shortened the operation time and improved the treatment outcomes and complication rates 7–9. Yet, few reports have offered endoscopists satisfactory methods for promptly managing bleeding events during the ESD procedure 10–12…”

Section: Introductionmentioning

confidence: 99%

Haemostasis treatment using dual red imaging during endoscopic submucosal dissection: a multicentre, open-label, randomised controlled trial

Fujimoto

Saito

Abe

et al. 2019

BMJ Open Gastroenterol

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IntroductionPatients scheduled to undergo oesophageal, gastric and colorectal endoscopic submucosal dissection (ESD) are to be investigated to verify the efficacy of dual red imaging (DRI) for establishing haemostasis during ESD.Methods and analysisThe trial is designed as a multicentre, open-label randomised, parallel-group, controlled intervention study. Registered patients will be randomly assigned to DRI and white light imaging (WLI) groups. In the DRI group, the mucosal incision and submucosal dissection will be performed by WLI, and haemostasis will be managed by DRI when bleeding occurs. In the WLI group, the mucosal incision and submucosal dissection are to be performed by WLI and the haemostasis management is to be performed by WLI. The primary endpoint is the time from the recognition of bleeding up to the achievement of complete haemostasis (haemostasis time). The secondary endpoints are the operation time, the proportion of cases in which perforation occurs, and the psychological stress experienced by the endoscopist during haemostasis treatment.Ethics and disseminationThis trial was approved by the Keio University Review Board for Clinical Trials (5 December 2016).DiscussionThis will be the first multicentre collaborative research using DRI for haemostasis treatment during ESD. When the safety and simplicity of DRI as a treatment for haemostasis during ESD can be proven, the ESD procedure can be simplified and disseminated more widely in clinical practice.Trial registration numberUMIN000025134

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Section: Introductionmentioning

confidence: 99%

Haemostasis treatment using dual red imaging during endoscopic submucosal dissection: a multicentre, open-label, randomised controlled trial

Fujimoto

Saito

Abe

et al. 2019

BMJ Open Gastroenterol

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“…In contrast, endoscopists can practice the two-fingers method during several different procedures, including biopsy, EMR snare, and clipping. Furthermore, the Smart Shooter has some structural issues and use limitations 13 . Unlike the Smart Shooter, the Nelaton Attachment can be used with several different types of ESD knives and endoscopes.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of “Nelaton Attachment” for endoscopic submucosal dissection of colorectal neoplasms

et al. 2019

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Background and study aims Although colorectal endoscopic submucosal dissection (ESD) has enabled high en bloc resection rates regardless of tumor size, colorectal ESD is still a challenging procedure. We developed a novel device called the Nelaton Attachment, which allows endoscopists to manipulate the ESD knives using two fingers of their left hand while holding the endoscope with their right hand. We retrospectively investigated the efficacy and safety of the Nelaton Attachment for colorectal ESD. We compared efficacy and safety between Nelaton Attachment and non-Nelaton Attachment groups, and also conducted an ex vivo experiment to evaluate the effect of the Nelaton Attachment. Patients and methods We retrospectively reviewed 36 consecutive patients with 37 colorectal tumors who had undergone ESD at Kishiwada Tokushukai Hospital and Naritatomisato Tokushukai Hospital between April 2016 and September 2018. The Nelaton Attachment was used for 22 of the 37 colorectal ESDs. In the ex vivo experiment, endoscopists inserted and withdrew an ESD knife 2 cm using two fingers of their left hand with and without the Nelaton Attachment. Results Median procedure time was significantly shorter in the Nelaton Attachment group (38 min [range 6 – 195 min]) compared to the non-Nelaton Attachment group (75 min [range 17 – 198 min]; P = 0.030). Median time to complete the ex vivo experiment five times was significantly faster with the Nelaton Attachment than without the Nelaton Attachment (P = 0.001). Conclusions Use of the Nelaton Attachment for colorectal ESD is feasible and safe, and may facilitate colorectal ESD procedures.

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“…One of the topics is “Contact point between medical treatment and minimally invasive surgical treatment for the malignancies of the digestive tract”. Recent advances in diagnostic imaging have made it possible to detect early cancers in the gastrointestinal tract, which could be cured by endoscopic treatments or minimally invasive surgery [1, 2]. On the other hand, limited surgery after multidisciplinary therapy (e.g., chemotherapy or chemoradiotherapy [CRT]) is one of the therapeutic strategies for treating locally advanced cancer.…”

Section: Introductionmentioning

confidence: 99%

Interaction between Medical Treatment and Minimally Invasive Surgical Treatment for the Malignancies of the Digestive Tract

et al. 2018

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Recently, endoscopic diagnosis and treatment methods for early cancer in the digestive tract have made rapid progress. As for surgery, laparoscopic and thoracoscopic techniques have achieved rapidly advancing development in the last 2 decades. Early detection of the malignant lesion and the evolution of endoscopic and surgical device enabled in performing the minimally invasive surgery. Collaboration of medical treatment and minimally invasive surgery for advanced cancer is ongoing in the case of some conditions and in a few institutes. In this review, the contents of the core symposia on “Interaction between medical treatment and minimally invasive surgical treatment for the malignancies of the digestive tract", held at the 11, 12 and 13th annual meeting of the Japanese Gastroenterological Association, are summarized. At each annual meeting, the core symposium focused primarily on gastric, colorectal, and esophageal cancer treatment. For gastric cancer, endoscopic resection and laparoscopic surgery were 2 important key words. For colorectal cancer, multidisciplinary therapy was a major key word. And for esophageal cancer, endoscopic resection, chemoradiotherapy, thoracoscopic surgery and salvage surgery were key words. Patients’ survival and quality of life are expected to further advance as a result of the collaboration of such therapeutic modalities.

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Feasibility of a Newly Developed Thumb Control Device for Simultaneous Manipulation of the Endoscope and Treatment Devices in Endoscopic Submucosal Dissection: A Clinical Feasibility Study

Cited by 5 publications

References 17 publications

Haemostasis treatment using dual red imaging during endoscopic submucosal dissection: a multicentre, open-label, randomised controlled trial

Haemostasis treatment using dual red imaging during endoscopic submucosal dissection: a multicentre, open-label, randomised controlled trial

Usefulness of “Nelaton Attachment” for endoscopic submucosal dissection of colorectal neoplasms

Interaction between Medical Treatment and Minimally Invasive Surgical Treatment for the Malignancies of the Digestive Tract

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