First clinical experience with esophageal ESD using a novel adjustable traction device

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Innovation

Background:

• Esophageal endoscopic submucosal dissection (ESD) benefits from traction methods, but existing techniques like clip-thread have limited directional control.
• Developing new devices for improved traction is crucial for enhancing esophageal ESD procedures.

Purpose of the Study:

• To investigate the clinical feasibility and usefulness of the novel over-tube type traction device, ENDOTORNADO, in esophageal ESD.
• To compare the outcomes of esophageal ESD using ENDOTORNADO (tESD) versus conventional ESD (cESD).

Main Methods:

• A single-center, retrospective study comparing six cases of tESD with 23 cases of cESD performed by the same operator.
• Evaluation of clinical treatment outcomes, including procedure speed and dissection time.

Main Results:

• All procedures achieved en bloc resection without intraoperative perforation.
• The tESD group demonstrated a significant increase in total procedure speed (30 vs. 23 mm²/min, P=0.046).
• Submucosal dissection time was significantly reduced in the tESD group (11 vs. 42 min, P=0.004).

Conclusions:

• The ENDOTORNADO device offers adjustable, multi-directional traction, proving clinically feasible for esophageal ESD.
• This device represents a potential advancement and a viable option for improving esophageal ESD procedures.