Clin Endosc.  2014 Nov;47(6):544-554. 10.5946/ce.2014.47.6.544.

Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)

Affiliations
  • 1Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 2Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. euschung@schmc.ac.kr
  • 4Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

Abstract

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.

Keyword

Equipment and supplies; Endoscopic submucosal dissection; Models, animal; Instrumentation
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