Clinical Endoscopy

Focused Review Series: Endoscopic Accessories Used for ESD

Accessory Devices Frequently Used for Endoscopic Submucosal Dissection: Hyuk Soon Choi, Hoon Jai Chun; Clin Endosc 2017;50(3):224-233. Published online May 31, 2017; DOI: https://doi.org/10.5946/ce.2017.070

Endoscopic submucosal dissection (ESD) is increasingly being considered an essential component of treatment for early gastrointestinal cancers and subepithelial tumors. The ESD technique owes its popularity to the development of sophisticated instruments used for ESD. With an increase in the number of ESD procedures performed, there is rapid development in the number and types of endoscopic accessory devices used for such procedures. Despite the large numbers of new devices developed and marketed, the use of ESD instruments and accessory devices is largely determined by individual preferences and experiences. Accessory devices frequently used during ESD are important tools for ESD techniques. Each instrument possesses characteristic advantages and disadvantages associated with its use, and no one instrument is superior in all respects to others. In this article, we review the characteristics of endoscopic electrical knives, cap and hood, and hemostatic devices commonly used in ESD.

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Review

Endoscopic Management of Nonvariceal Upper Gastrointestinal Bleeding: State of the Art: Naoki Muguruma, Shinji Kitamura, Tetsuo Kimura, Hiroshi Miyamoto, Tetsuji Takayama; Clin Endosc 2015;48(2):96-101. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.96

Abstract PDF PubReader ePub

Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common reasons for hospitalization and a major cause of morbidity and mortality worldwide. Recently developed endoscopic devices and supporting apparatuses can achieve endoscopic hemostasis with greater safety and efficiency. With these advancements in technology and technique, gastroenterologists should have no concerns regarding the management of acute upper GI bleeding, provided that they are well prepared and trained. However, when endoscopic hemostasis fails, endoscopy should not be continued. Rather, endoscopists should refer patients to radiologists and surgeons without any delay for evaluation regarding the appropriateness of emergency interventional radiology or surgery.

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14,986 View
225 Download
5 Web of Science
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Original Article

Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video): Chang-Il Kwon, Gwangil Kim, Il-Kwun Chung, Won Hee Kim, Kwang Hyun Ko, Sung Pyo Hong, Seok Jeong, Don Haeng Lee; Clin Endosc 2014;47(6):544-554. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.544

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.

Methods

This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.

Results

A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm²/sec vs. 1.57 mm²/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.

Conclusions

ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

Citations

Citations to this article as recorded by

Comparison of synchronous dual wavelength diode laser versus conventional endo-knives for esophageal endoscopic submucosal dissection: an animal study
Jian Tang, Shufang Ye, Xueliang Ji, Jun Li, Feng Liu
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Georgios Mavrogenis, Juergen Hochberger, Pierre Deprez, Morteza Shafazand, Dimitri Coumaros, Katsumi Yamamoto
Scandinavian Journal of Gastroenterology.2017; 52(4): 486. CrossRef

8,073 View
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