Feasibility of ultrathin endoscope for esophageal endoscopic submucosal dissection

Abstract

Background and study aims Endoscopic submucosal dissection (ESD) is widely performed for superficial esophageal cancer, but stricture after extensive resection is a major clinical problem. Using an ultrathin endoscope would enable endoscopists to approach lesions beyond the stricture. We evaluated the feasibility of an ultrathin endoscope for esophageal ESD. Methods To perform ESD with an ultrathin endoscope, we developed a transparent hood and ESD knife. A total of 24 esophageal ESDs were performed by two endoscopists with excised and live porcine esophaguses. A GIF-Q260 J and Dual knife were used in the conventional group and the GIF-XP260NS and a newly developed knife were used in the ultrathin group. En bloc resection rates, perforation rates, and procedure times were compared. Results All 24 lesions were resected en bloc without perforation. The mean procedure time was longer in the ultrathin group, although not significantly so (274.3 ± 81.8 s vs 435.8 ± 313.9 s, respectively; P = 0.22). Conclusion Although the procedure time was longer in the ultrathin group, en bloc resection was performed without any perforation. The findings indicate that esophageal ESD with an ultrathin endoscope is feasible.

Unsedated Transnasal Endoscopy: A Safe, Well-Tolerated and Accurate Alternative to Standard Diagnostic Peroral Endoscopy

“…An oral approach is still favored when therapy or hemostasis is likely to be required, although, as technology continues to advance and further evidence emerges [7], there is an increasing role for therapeutic TNE (such as for strictures [16], percutaneous endoscopic gastrostomy [17][18][19] and feeding tube placement [20], endoscopic submucosal dissection [21,22] and Botulinum toxin (Botox) injections [23]). Recent studies have also explored the use of uTNE in the pre-screening of bariatric surgery patients, with results suggesting that it is a well-tolerated examination and is an appropriate choice in morbidly obese patients due to minimal cardiovascular stress being induced [24,25].…”

Endoscopic submucosal dissection using an ultrathin endoscope for esophageal squamous cell carcinoma with anastomotic stenosis

“…In ESD for ESCC beyond the stricture, balloon dilation is commonly performed until a conventional endoscope may pass through. The ultrathin endoscope does not require balloon dilation, and the transparent hood mounted at the distal end of the ultrathin endoscope provides a more rapid approach to the submucosa than a conventional endoscope (1,2). Esophageal ESD with an ultrathin endoscope is a useful endoscopic treatment option for ESCC with stricture (1-3).…”

Gastrointestinal Residue Removal Using a Balloon Overtube under Ultrathin Endoscopic Navigation: Ex Vivo and In Vivo Experimental Studies

“…A novel hemostatic forceps with a 2.3 mm diameter (RAICHO, KANEKA, Osaka, Japan), suitable for the ultrathin endoscopes (FUJIFILM, Tokyo, Japan) with a 2.4 mm diameter forceps scope channel, has been made recently available in clinical practice. Several authors reported that the RAICHO was efficacious for endoscopic hemostasis during endoscopic submucosal dissection using the ultrathin endoscope [18,19]. Accordingly, the simultaneous procedure seems possible.…”