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How I do it: Flexible 3-D endoscope for endoscopic submucosal dissection.

Philip W Y Chiu1, Hon Chi Yip1, Xian Feng Xia1

  • 1Division of Upper GI and Metabolic Surgery, Department of Surgery, Institute of Digestive Disease, Chow Yuk Ho Technology Center for Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|December 15, 2018
PubMed
Summary

Three-dimensional (3-D) endoscopes improve depth perception for endoscopic submucosal dissection (ESD). This technology enhances safety and effectiveness, offering a promising advancement for minimally invasive gastrointestinal procedures.

Keywords:
3-D endoscopyduodenal sessile polypearly colorectal cancerearly gastric cancerendoscopic submucosal dissection

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Medical Imaging

Background:

  • Endoscopic submucosal dissection (ESD) is a complex procedure often hindered by poor depth perception.
  • Developing advanced endoscopic tools is crucial for improving ESD outcomes.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of using a 3-D endoscope for ESD.
  • To compare the performance of experienced versus novice endoscopists using 3-D endoscopy in a preclinical setting.

Main Methods:

  • Preclinical porcine model comparing experienced and novice endoscopists performing ESD with a 3-D endoscope.
  • Prospective clinical evaluation of 3-D endoscope-assisted ESD in ten patients undergoing procedures in the stomach, duodenum, and lower gastrointestinal tract.

Main Results:

  • In the preclinical study, experienced endoscopists had significantly shorter operative times per surface area (197.9 s/cm² vs 434.7 s/cm²).
  • All procedures in the clinical study were completed without complications, with one failure due to tumor location.
  • Mean operative time was 99.4 minutes (391 s/cm²), and endoscopists reported no motion sickness, though assistants experienced some dizziness.

Conclusions:

  • The 3-D endoscope facilitates safe and effective ESD by enhancing depth perception.
  • 3-D endoscopy represents a valuable advancement for ESD, potentially improving procedural efficiency and outcomes.