Gastric endoscopic submucosal dissection under steady pressure automatically controlled endoscopy (SPACE); a...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Technology

Background:

• Steady Pressure Automatically Controlled Endoscopy (SPACE) offers automatic insufflation, a novel approach for gastrointestinal procedures.
• While promising for esophageal procedures, its application in gastric interventions remains unevaluated.

Purpose of the Study:

• To assess the feasibility and safety of SPACE in the stomach.
• To determine if SPACE can prevent complications associated with manual insufflation during endoscopic procedures.

Main Methods:

• A multicenter, randomized preclinical animal study involving swine.
• Experiment 1: Gastric Endoscopic Submucosal Dissection (ESD) under SPACE vs. manual insufflation (n=17).
• Experiment 2: Gastroscopy in perforated stomachs under SPACE vs. manual insufflation (n=10) to monitor pressure dynamics.

Main Results:

• Gastric ESD was successfully completed in all animals using SPACE.
• SPACE maintained stable intra-gastric and intra-abdominal pressures, unlike manual insufflation which led to excessive pressure elevation.
• ESD procedure time showed a trend towards reduction with SPACE, though not statistically significant.

Conclusions:

• SPACE is a feasible and safe endoscopic modality for complex gastric procedures like ESD.
• SPACE demonstrates potential in mitigating risks linked to excessive insufflation during gastrointestinal endoscopy.