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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
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Related Experiment Video

Updated: Jan 9, 2026

Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
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EndoTrac-Assisted vs. Conventional ESD in Superficial Gastric Neoplasms: A Multicenter Randomized Controlled Trial.

Ryosuke Ishida1, Tomoya Sako2, Yoshinobu Yamamoto3

  • 1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Digestion
|December 3, 2025
PubMed
Summary

EndoTrac-assisted endoscopic submucosal dissection (ET-ESD) did not shorten procedure times overall. However, ET-ESD showed potential benefits for trainees and specific lesion types in early gastric cancer treatment.

Keywords:
Endoscopic submucosal dissectionGastric neoplasmsMulticenter studyRandomized controlled trialTraction

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Medical Device Technology

Background:

  • Endoscopic submucosal dissection (ESD) is a complex curative treatment for early gastric cancer.
  • The EndoTrac traction device aims to improve maneuverability during ESD procedures.
  • Evaluating the impact of assistive devices on ESD outcomes is crucial for advancing minimally invasive cancer treatment.

Purpose of the Study:

  • To assess if EndoTrac-assisted ESD (ET-ESD) improves outcomes compared to conventional ESD (C-ESD).
  • To determine the primary endpoint of ESD procedure time.
  • To analyze secondary endpoints including efficacy, safety, and device-related outcomes.

Main Methods:

  • A multicenter, single-blind, randomized controlled trial involving 142 patients.
  • Patients were assigned to either ET-ESD (n=72) or C-ESD (n=70).
  • Data collected included procedure time, resection rates, adverse events, and operator experience.

Main Results:

  • Overall median procedure times were similar between ET-ESD (53.5 min) and C-ESD (57.0 min).
  • Among trainees, ET-ESD significantly reduced procedure time (59.0 vs. 85.5 min; P=0.02).
  • Subgroup analyses indicated shorter ET-ESD times for trainees with specific lesion characteristics and in low-volume centers.

Conclusions:

  • ET-ESD did not demonstrate a significant reduction in procedure time for the overall patient cohort.
  • Exploratory findings suggest ET-ESD may benefit trainees, smaller lesions, challenging locations, and lower-volume centers.
  • Further research may clarify the specific patient and procedural factors where ET-ESD offers advantages.