Endoscopic submucosal tunnel dissection using a novel bracing basket: An animal feasibility study

Area of Science:

• Gastroenterology
• Surgical Innovation
• Endoscopic Procedures

Background:

• Endoscopic submucosal dissection (ESD) is a minimally invasive technique for gastrointestinal lesion resection.
• Endoscopic submucosal tunnel dissection (ESTD) offers an alternative approach, particularly for specific lesion types.
• Improvements in instrumentation are crucial for enhancing the efficacy and safety of ESTD.

Purpose of the Study:

• To evaluate the feasibility and efficacy of a novel bracing basket designed for Endoscopic submucosal tunnel dissection (ESTD).
• To compare the performance of bracing basket-assisted ESTD with conventional ESTD in an animal model.
• To assess procedural quality control and identify any adverse events associated with the novel device.

Main Methods:

• A prospective randomized, comparative, experimental animal study was conducted.
• Twenty ESTD procedures (6 esophageal, 14 gastric) were performed on four pigs.
• Techniques compared included bracing basket-assisted ESTD and conventional ESTD.

Main Results:

• Both techniques achieved a 100% technical success rate with en bloc resections.
• Bracing basket-assisted ESTD showed a significantly quicker cutting speed in gastric procedures (p < 0.05).
• One bleeding event occurred with the bracing basket, and one perforation with conventional ESTD.

Conclusions:

• The novel bracing basket is feasible for ESTD and demonstrates potential advantages over conventional methods, particularly in gastric resections.
• The device facilitates a faster cutting speed, contributing to procedural efficiency.
• Further comparative studies involving larger gastric or colorectal lesions are warranted to fully establish the benefits of this novel bracing basket.