Related Experiment Video
Updated: Nov 16, 2025
06:42
Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
Published on: March 3, 2023
3.4K
Assistant skill in gastric endoscopic submucosal dissection using a clutch cutter
Mitsuru Esaki1, Toshiki Horii2, Ryoji Ichijima2
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
World Journal of Gastrointestinal Surgery
|March 1, 2021
Summary
Expert assistance significantly improves outcomes in endoscopic submucosal dissection using a clutch cutter (ESD-C). Trainees performing ESD-C with expert help completed procedures faster and with fewer difficulties compared to those with non-expert assistance.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Education
Background:
- Clutch cutter (ESD-C) is vital for gastrointestinal tumor dissection.
- Assistant's role in rotating the device and grasping tissue is critical for ESD-C success.
- Variability in assistant skill may impact ESD-C technical outcomes.
Purpose of the Study:
- To evaluate the impact of assistant skill level on gastric endoscopic submucosal dissection using a clutch cutter (ESD-C).
- To assess technical outcomes in an ex vivo porcine model with varying assistant expertise.
Main Methods:
- Pilot study using an ex vivo porcine stomach model with mock lesions.
- 32 ESD-C procedures performed by 16 trainees, each assisted by an expert and a non-expert.
- Primary outcome: total procedure time; Secondary outcomes: en bloc resection, complete resection, perforation rates, and procedure speed.
Main Results:
- Expert assistance (ESD-C-E) significantly reduced total procedure time (12.9 min vs. 21.9 min, P=0.001).
- En bloc resection (100%) and complete resection (100% vs. 93.8%) rates were higher with expert assistance.
- Assistant skill was strongly associated with ESD difficulty (OR 16.5), with no perforations in either group.
Conclusions:
- Expert assistance is a crucial factor for trainees performing endoscopic submucosal dissection with a clutch cutter.
- Improving assistant training may enhance the technical success and efficiency of ESD-C procedures.
