Endoscopic submucosal dissection with a novel traction method using a steerable grasper: a feasibility study in a...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Innovation

Background:

• Endoscopic submucosal dissection (ESD) is complex, with outcomes influenced by operator skill, lesion size, and location.
• Adequate visualization of the submucosal plane is critical for safe and effective ESD procedures.

Purpose of the Study:

• To assess the feasibility, efficacy, and safety of a new traction method using an over-the-scope steerable grasper.
• To determine if this grasper improves dissection plane exposure during gastric ESD.

Main Methods:

• A novel over-the-scope steerable grasper was employed for traction during ESD procedures.
• The technique was applied to various gastric locations in porcine models.

Main Results:

• Twenty-four ESDs were successfully performed in porcine stomachs (antrum, body, cardia) without complications.
• Complete en bloc resections were achieved in all cases, with a mean specimen size of 44.92 mm.
• Optimal dissection planes were consistently obtained through grasper control, with a mean dissection time of 15.08 minutes.

Conclusions:

• The over-the-scope steerable grasper technique is technically feasible, effective, and safe for gastric ESD.
• This method provides dynamic and controlled traction, enhancing the dissection plane exposure.
• The grasper facilitates successful ESD across different gastric locations in a porcine model.