A new instrument for endoscopic submucosal dissection (with videos)

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Device Development

Background:

• Endoscopic submucosal dissection (ESD) is effective for early neoplasms but technically demanding.
• Current ESD procedures often require multiple instruments, increasing complexity and time.

Purpose of the Study:

• To design, develop, and evaluate a novel, single instrument for endoscopic submucosal dissection.
• To assess the feasibility and efficiency of the new instrument in a preclinical model.

Main Methods:

• A feasibility study was conducted using an acute porcine model.
• Gastric ESD procedures, including incision, dissection, and coagulation, were performed using the prototype single instrument.
• The instrument's performance and time to complete resection were evaluated.

Main Results:

• The new instrument successfully facilitated all required ESD steps.
• The mean total procedure time was 48.5 ± 9.9 minutes.
• Mean time for incision and dissection was 37.8 ± 8.8 minutes.

Conclusions:

• The developed instrument demonstrated potential advantages for ESD by consolidating multiple functions.
• The technique of lifting submucosal fibers during dissection may reduce perforation risk.
• Further comparative studies with larger lesions and standard ESD are warranted.