Initial experience with Barrett's strip endoscopic mucosal excision: a new Barrett's excision device

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Barrett's Esophagus Research

Background:

• Current Barrett's mucosa resection techniques are time-consuming and have variable success rates.
• A novel device and technique for strip endoscopic mucosal resection (SEMR) using a cold excision blade are presented.
• This approach aims to improve the efficiency and efficacy of Barrett's mucosa resection.

Purpose of the Study:

• To evaluate the design characteristics and performance of a new transoral strip mucosal excision device.
• To assess the safety and feasibility of the SEMR device in ex vivo and in vivo experiments.
• To determine the reproducibility of excision depth and inclusion of the muscularis mucosa.

Main Methods:

• Retrospective review of ex vivo and in vivo animal and human esophagus experiments.
• Serial evaluation of device depth, size, shape, and excision technique.
• Performance assessment through 10 excisions on cadaveric human esophagi and 6 in vivo experiments.

Main Results:

• The SEMR device enabled precise capsule positioning and satisfactory excision size and depth.
• Excision specimens from human esophagi averaged 0.297 mm in thickness.
• Muscularis mucosa was included in 99.8% of examined fields, demonstrating effective resection.

Conclusions:

• Satisfactory and reproducible excision depth was achieved with the SEMR device.
• The device demonstrated safety and feasibility in initial in vivo experiments.
• Further animal survival studies and clinical trials are necessary to establish the SEMR device's role in managing Barrett's esophagus.