Endoscopic submucosal dissection by using a grasping-type scissors forceps: a preliminary clinical study (with video)

Area of Science:

• Gastroenterology
• Surgical Innovation
• Endoscopic Procedures

Background:

• Endoscopic submucosal dissection (ESD) using traditional knives presents technical challenges and a high complication rate, including perforation and bleeding.
• Difficulty in precisely fixing the knife to the target lesion contributes to unexpected incisions and adverse events.
• A novel grasping-type scissors forceps (GSF) was developed to improve tissue fixation and enable precise incision using electrosurgical current.

Purpose of the Study:

• To assess the efficacy and safety of the grasping-type scissors forceps (GSF) for endoscopic submucosal dissection (ESD) in removing gastric neoplasms.
• To determine if GSF can reduce the complication rates associated with conventional ESD techniques.

Main Methods:

• A prospective, uncontrolled, single-center study was conducted involving four patients with early gastric neoplastic lesions.
• The GSF was used to incise around the lesion and grasp/cut submucosal tissue via electrosurgical current for excision.
• Technical success and complication rates were the primary outcome measures.

Main Results:

• All gastric neoplasms were successfully treated using the GSF with ease and safety.
• No unexpected incisions, delayed hemorrhage, or perforation occurred during the procedures.
• En bloc resection with negative margins was achieved in all four cases.

Conclusions:

• Endoscopic submucosal dissection (ESD) using the grasping-type scissors forceps (GSF) demonstrated to be an easy, safe, and technically efficient method.
• The GSF shows promise for the resection of gastrointestinal neoplasms, potentially improving patient outcomes.
• Further studies with larger patient cohorts are warranted to confirm these findings.