Usefulness of a novel slim type FlushKnife-BT over conventional FlushKnife-BT in esophageal endoscopic submucosal dissection

Ohara, Yoshiko; Toyonaga, Takashi; Hoshi, Namiko; Tanaka, Shinwa; Baba, Shinichi; Takihara, Hiroshi; Kawara, Fumiaki; Ishida, Tatsuro; Morita, Yoshinori; Umegaki, Eiji; Azuma, Takeshi

doi:10.3748/wjg.v23.i9.1657

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…These are complex therapeutic endoscopic procedures and carry a risk of collateral damage to the muscle or mucosa, especially when performed during the learning curve [12]. The technical difficulty associated with these procedures can be reduced with experience as well as through improvement in the currently available electrosurgical knives [4,7,13].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

et al. 2020

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Background and study aims Recent innovations in devices and techniques have revolutionized the field of endoscopic resection procedures. In this study, we evaluated the safety and feasibility of endoscopic submucosal dissection and tunneling procedures with a novel, multipurpose bipolar device. Patients and methods Data from consecutive patients who underwent per-oral endoscopic myotomy (POEM), submucosal tunneling endoscopic resection (STER), and endoscopic submucosal dissection (ESD) using a novel bipolar device (December 2019 to February 2020) were analyzed retrospectively. Procedure duration, technical success, and adverse events (AEs) were recorded. Results A total of 10 procedures were performed using the novel bipolar device during the study period. The procedures included POEM (n = 7), STER for esophageal sub-epithelial tumor (n = 1), ESD for rectal polyp (n = 1), and gastric neuroendocrine tumor (n = 1). POEM was successfully completed in all patients. In patients who underwent STER and ESD, en-bloc resection was achieved in all. Mean procedure time for submucosal tunneling procedures (POEM and STER) was 59.12 ± 31.12 minutes. The procedures were completed without the requirement for exchange of accessories in eight cases (80 %). There were no major AEs. Mild and moderate AEs occurred during POEM and included capno-peritoneum (n = 1), retroperitoneal CO2 (n = 1), and empyema (n = 1). Conclusion ESD and tunneling procedures can be safely performed without the need for exchange of accessories using a novel bipolar device. Randomized comparison with conventional knives isrequired to confirm the utility of this device.

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Section: Discussionmentioning

confidence: 99%

Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

et al. 2020

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“…In our hospital, we mainly use the FlushKnife BT-S for colorectal ESD. This knife has some merits in terms of its water jet function, which means that endoscopists can inject normal saline into the submucosal layer using the knife without the need to exchange it with other needles 8 9 10 .…”

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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“…Theoretically, a thicker body/tube of knife is better in allowing for more liquid flow but at the expense of knife insertion time and vacuum or suction function under knife in the channel. A previous study showed a little decrease of water injection amount in the air with Flush knife BT-S (2–15 ml/min) compared to Flush knife [ 8 ]. However, in the current study using porcine stomach, the Flush knife BT-S did not show significant water jet function impairment compared to the Flush knife BT.…”

Section: Discussionmentioning

confidence: 99%

“…The novel narrow ESD knife (Flush knife BT-S 2.0 mm, diameter: 2.2 mm, Fujifilm Co., Tokyo, Japan) and the knife with regular diameter (Flush knife BT 2.0 mm, diameter: 2.6 mm, Fujifilm Co., Tokyo, Japan) were utilized in this study ( Figure 1() ) [ 8 ]. With respect to the diameter of the Flush knife BT-S, it is a slim design but with only the front 3 cm tip part made slightly thick (2.6 mm) to anchor and ensure stable movement of the knife during dissection.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of a Novel Narrow Knife with Water Jet Function for Colorectal Endoscopic Submucosal Dissection

Yoshida

Toyonaga

Murakami

et al. 2017

Gastroenterology Research and Practice

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Backgrounds With respect to the knife's design in colorectal endoscopic submucosal dissection (ESD), diameter, water jet function, and electric power are important because these relate to efficient dissection. In this study, we analyzed a novel, narrow ball tip-typed ESD knife with water jet function (Flush knife BT-S, diameter: 2.2 mm, length: 2000 mm, Fujifilm Co., Tokyo, Japan) compared to a regular diameter knife (Flush knife BT, diameter: 2.6 mm, length: 1800 mm). Methods In laboratory and clinical research, electric power, knife insertion time, vacuum/suction amount with knife in the endoscopic channel, and water jet function were analyzed. We used a knife 2.0 mm long for BT-S and BT knives. Results The BT-S showed faster mean knife insertion time (sec) and better vacuum amount (ml/min) compared to the BT (insertion time: 16.7 versus 21.6, p < 0.001, vacuum amount: 38.0 versus 14.0, p < 0.01). Additionally, the water jet function of the BT-S was not inferior. In 39 colorectal ESD cases in two institutions, there were mean 4.7 times (range: 1–28) of knife insertion. Suction under knife happened 59% (23/39) and suction of fluid could be done in 100%. Conclusions Our study showed that the narrow knife allows significantly faster knife insertion, better vacuum function, and effective clinical results.

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Usefulness of a novel slim type FlushKnife-BT over conventional FlushKnife-BT in esophageal endoscopic submucosal dissection

Cited by 9 publications

References 27 publications

Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

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

Efficacy of a Novel Narrow Knife with Water Jet Function for Colorectal Endoscopic Submucosal Dissection

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