Feasibility of using an led-probe in third-space endoscopy: a clinical study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Devices

Background:

• Third-space endoscopy is a minimally invasive technique for gastrointestinal conditions.
• Incomplete myotomy is a common cause of procedural failure.
• Lighting devices can prevent iatrogenic injuries during endoscopy.

Purpose of the Study:

• To evaluate the feasibility of using a hand-made Light Emitting Diode (LED) probe (LP) in third-space endoscopic procedures.
• To assess the safety and efficacy of the LP in guiding submucosal tunnel creation and myotomy confirmation.

Main Methods:

• Prospective study conducted at a tertiary-care center from December 2016 to January 2019.
• Included peroral endoscopic myotomy (POEM) and gastric peroral endoscopic myotomy (G-POEM) procedures.
• Excluded patients with pseudoachalasia, peptic ulcer, normal gastric emptying scintigraphy, or prepyloric tumors. LP was used for guidance and confirmation.

Main Results:

• Seventy procedures (42 POEM, 28 G-POEM) were analyzed.
• Median procedure times were 50 min for POEM and 60 min for G-POEM.
• Clinical success at 6 months was 100% for POEM and 85.7% for G-POEM, with mild adverse events in 9.4% and 14.2% respectively. Integrated relaxation pressure improved significantly (p < 0.001).

Conclusions:

• The hand-made LED-probe (LP) is a promising tool for third-space endoscopy.
• It effectively guides submucosal tunnel creation and confirms myotomy.
• The LP demonstrates excellent safety and efficacy in clinical practice for POEM and G-POEM.