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Related Experiment Videos

Chemically assisted endoscopic mechanical submucosal dissection by using mesna.

Kazuki Sumiyama1, Christopher J Gostout, Elizabeth Rajan

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Gastrointestinal Endoscopy
|February 26, 2008
PubMed
Summary
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Chemically assisted endoscopic mechanical submucosal dissection (CAEMSD) using mesna significantly reduced tissue resistance and dissection difficulty in porcine models. This technique shows promise for facilitating mucosal resection in surgical procedures.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Medical Device Technology

Background:

  • Mesna (sodium-2-mercaptoethanesulfonate), a thiol compound, is utilized to aid tissue dissection in surgical settings.
  • Endoscopic submucosal dissection (ESD) is a minimally invasive technique for resecting gastrointestinal lesions.

Purpose of the Study:

  • To assess the technical feasibility and efficacy of chemically assisted endoscopic mechanical submucosal dissection (CAEMSD) employing mesna.
  • To determine if mesna improves the ease and success of submucosal dissection.

Main Methods:

  • A controlled, blind, in vivo trial was conducted using porcine models in a non-survival laboratory setting.
  • Mesna or a control solution was injected submucosally, followed by mechanical isolation and resection of target mucosal areas using balloon dissection and a hook-knife.

Related Experiment Videos

  • Histological examination of necropsy and mucosal specimens was performed for both groups.

    • Main Results:

    • En bloc resection was achieved in all mesna-treated cases and most control cases.
    • Mesna significantly decreased tissue resistance during initial balloon-catheter insertion and overall submucosal dissection difficulty (P < .05).
    • Histological analysis revealed no significant differences between the mesna and control groups.

    Conclusions:

    • Chemically assisted endoscopic mechanical submucosal dissection (CAEMSD) represents a novel method for improving mucosal resection.
    • Mesna demonstrates potential as an adjunct to facilitate endoscopic submucosal dissection procedures.