Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Innovation

Background:

• Endoscopic submucosal dissection (ESD) is a complex procedure often requiring multiple accessory changes, increasing procedure time.
• A novel versatile knife integrating advantages of conventional knives was developed to streamline ESD.
• The need for improved efficiency and reduced accessory use in ESD procedures is critical.

Purpose of the Study:

• To compare the efficacy, safety, and histological quality of ESD using a novel versatile knife versus conventional knives.
• To evaluate the impact of a new versatile knife on procedure time and accessory changes during ESD.
• To assess the technical feasibility and safety profile of the innovative versatile knife in ESD.

Main Methods:

• An in vivo animal study utilizing mini-pigs to compare two ESD modalities.
• Resected specimens were evaluated for completeness, and histopathological examinations assessed quality control and adverse events.
• Procedure time and cutting speed were documented for each modality.

Main Results:

• Eighteen en bloc resections were safely completed using either the versatile knife or a combination of conventional knives.
• No statistically significant differences were observed in procedure time (456s vs. 355s) or cutting speed (1.983 mm²/sec vs. 1.57 mm²/sec).
• The rate of adverse events and the histological quality of resections were comparable between the two methods.

Conclusions:

• Endoscopic submucosal dissection using the versatile knife is an easy, safe, and technically efficient method.
• The novel versatile knife demonstrates comparable efficacy and safety to conventional knife combinations in ESD.
• This versatile knife represents a promising advancement for improving ESD procedures.