A novel endoscopic submucosal dissection technique with robust and adjustable tissue traction

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Procedures

Background:

• Endoscopic submucosal dissection (ESD) is a key technique for esophageal lesion resection.
• Achieving adequate tissue traction remains a challenge in esophageal ESD.
• A novel overtube-assisted full-traction ESD (tESD) technique was developed.

Purpose of the Study:

• To evaluate the feasibility and safety of the new tESD technique.
• To assess the efficacy of tESD in achieving adequate tissue traction.
• To compare tESD with conventional ESD in a porcine model.

Main Methods:

• The tESD technique utilizes grasping forceps through an overtube's side channel for controlled tissue traction.
• En bloc resection rate, procedure time, adverse events, and dissection efficiency were measured.
• A porcine model was used, comparing tESD (n=10) with conventional ESD (n=10).

Main Results:

• tESD demonstrated robust and adjustable tissue traction.
• All lesions were resected en bloc with no complications using tESD.
• Procedure times were similar, but tESD required significantly less submucosal injection (P<0.01).

Conclusions:

• tESD offers effective tissue traction, potentially enhancing esophageal ESD efficiency.
• This inexpensive technique is a promising option for esophageal ESD.
• Further clinical evaluation is warranted to confirm these findings.