Endoscopic submucosal dissection and tunneling procedures using a novel all-in-one bipolar device

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Innovation

Background:

• Innovations in endoscopic resection devices and techniques are transforming gastrointestinal procedures.
• Evaluating novel devices is crucial for advancing minimally invasive surgical options.
• This study focuses on a new multipurpose bipolar device for complex endoscopic resections.

Purpose of the Study:

• To assess the safety and feasibility of using a novel bipolar device for endoscopic submucosal dissection (ESD) and tunneling procedures.
• To evaluate the device's performance in per-oral endoscopic myotomy (POEM), submucosal tunneling endoscopic resection (STER), and ESD.

Main Methods:

• Retrospective analysis of consecutive patients undergoing POEM, STER, or ESD with a novel bipolar device (December 2019 - February 2020).
• Data collected included procedure duration, technical success rates, and adverse events (AEs).
• Ten procedures were analyzed: 7 POEM, 1 STER, 1 ESD for rectal polyp, and 1 ESD for gastric neuroendocrine tumor.

Main Results:

• All 7 per-oral endoscopic myotomy (POEM) procedures were technically successful.
• En-bloc resection was achieved in all submucosal tunneling endoscopic resection (STER) and endoscopic submucosal dissection (ESD) cases.
• 80% of procedures were completed without accessory exchange; mean procedure time for tunneling was 59.12 minutes. No major AEs occurred, though mild/moderate AEs were noted in POEM cases.

Conclusions:

• Endoscopic submucosal dissection (ESD) and tunneling procedures can be safely performed using the novel bipolar device without requiring accessory exchange.
• The device demonstrates feasibility for various complex endoscopic resections.
• Further randomized trials comparing this device to conventional knives are needed to confirm its utility.