Multibending scope use for reduction of perforation risks in endoscopic submucosal dissection

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic submucosal dissection (ESD) is a minimally invasive technique for gastrointestinal lesion resection.
• Certain anatomical locations present challenges for single-scope ESD, potentially impacting resection quality and safety.
• The development of advanced endoscopic tools is crucial for overcoming these limitations.

Purpose of the Study:

• To identify challenging sites for single-scope ESD.
• To evaluate the efficacy, en-bloc resection, R0 resection, and perforation rates using a multibending scope in these difficult areas.
• To assess the impact of scope conversion on ESD outcomes.

Main Methods:

• A retrospective analysis of 315 lesions undergoing ESD was conducted.
• The study recorded instances where a single-channel scope (Q260J) was insufficient.
• Conversion to a dual-channel multibending scope (2TQ260M) was performed in challenging situations to assess its effectiveness.

Main Results:

• The multibending scope was frequently used in the gastric fornix (88.9%) and along the lesser curvature (37.1%).
• Of 315 lesions, ESD was completed with the single scope at only four sites.
• No perforations or ineffective resections occurred after switching to the multibending scope; all specimens achieved en-bloc and R0 resection.

Conclusions:

• The multibending scope is effective for ESD in anatomically challenging locations.
• Scope conversion enhances en-bloc and R0 resection rates while minimizing perforation risk.
• This technology improves clinician confidence and success in complex ESD procedures.