Colorectal endoscopic submucosal dissection using novel articulating devices: a comparative study in a live porcine model

Surg Endosc. 2019 Feb;33(2):651-657. doi: 10.1007/s00464-018-6408-5. Epub 2018 Sep 5.

Abstract

Background and aims: Colonic endoscopic submucosal dissection (ESD) is time-consuming and bears a high risk of perforation. The aim of the present study was to compare the safety and efficacy between novel articulating devices and conventional ESD in live porcine colon models.

Methods: Thirty ESDs in ten pigs were carried out at three different locations (15, 25, and 35 cm from the anus) by the conventional method (n = 15) and by the new method (n = 15). Procedure times, adverse events (perforation, bleeding), and damage to the muscular layer were recorded, and the ESD time per unit area of the specimens was calculated.

Results: The perforation rate using the conventional method was 6.7% (1/15), whereas that using the new method was 0.0%. The number of sites of muscular damage was significantly lower in the new than conventional method (6 vs. 37, respectively; P = 0.024). The mean procedure time was significantly shorter in the new than conventional method (4.6 ± 2.0 vs. 7.0 ± 4.1 min/cm2, respectively; P = 0.042).

Conclusions: Use of the new ESD method allows for reduced adverse events and a shortened resection time.

Keywords: Articulating device; Colon; ESD; Endoscopic submucosal dissection; Novel device; Standard endoscope.

MeSH terms

  • Animals
  • Colorectal Neoplasms / surgery*
  • Endoscopic Mucosal Resection* / instrumentation
  • Endoscopic Mucosal Resection* / methods
  • Models, Anatomic
  • Swine
  • Treatment Outcome