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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Fission is the division of a single entity into two or more parts, which regenerate into separate entities that resemble the original. Organisms in the Archaea and Bacteria domains reproduce using binary fission, in which a parent cell splits into two parts that can each grow to the size of the original parent cell. This asexual method of reproduction produces cells that are all genetically identical.
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A New Ex Vivo Model for the Evaluation of Endoscopic Submucosal Injection Material Performance
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A novel injectable thermo-sensitive binary hydrogels system for facilitating endoscopic submucosal dissection

Yan Zhu1, Jia-Xin Xu1, Jing Cheng1

  • 1Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Shanghai, China.

United European Gastroenterology Journal
|July 19, 2019
PubMed
Summary

A novel thermo-sensitive hydrogel system effectively elevates tissue during endoscopic submucosal dissection. This innovative solution offers improved mucosal lifting and cleaner wounds compared to traditional saline injections.

Keywords:
Thermo-sensitive binary hydrogels systemendoscopic submucosal dissectionsubmucosal injection

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Area of Science:

  • Biomaterials Science
  • Gastroenterology
  • Surgical Innovation

Background:

  • Endoscopic submucosal dissection (ESD) requires a stable submucosal cushion for optimal outcomes.
  • Thermo-sensitive hydrogels offer potential as submucosal injection solutions due to their unique phase transition properties.

Purpose of the Study:

  • To prepare and evaluate a thermo-sensitive binary hydrogel system (poloxamer 407 and poloxamer 188) for submucosal injection in ESD.
  • To assess the hydrogel's mucosal lifting capacity and its efficacy in ESD procedures.

Main Methods:

  • Formulations of poloxamer 407 and poloxamer 188 in saline were prepared and characterized for gelation temperature and viscosity.
  • In vitro studies on porcine stomach models compared hydrogel and saline for mucosal lifting.
  • In vivo ESD procedures in a porcine model evaluated the efficacy of the hydrogel versus saline.

Main Results:

  • Two hydrogel formulations exhibited ideal gelation temperatures; one showed significantly higher injection pressure.
  • ESD procedures using the hydrogel required a smaller injection volume compared to saline.
  • The hydrogel group demonstrated significantly cleaner postoperative wounds.

Conclusions:

  • The thermo-sensitive binary hydrogel system, particularly formulation I, is a superior submucosal injection solution for ESD.
  • The hydrogel provides effective mucosal elevation, reduces injection volume, and results in improved wound quality.