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

Kurato Miyazaki; Motohiko Kato; Motoki Sasaki; Kentaro Iwata; Teppei Masunaga; Yoko Kubosawa; Yukie Hayashi; Mari Mizutani; Yusaku Takatori; Noriko Matsuura; Atsushi Nakayama; Kaoru Takabayashi; Kiyokazu Nakajima; Takanori Kanai; Naohisa Yahagi

doi:10.1055/a-2011-1836

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

Endosc Int Open. 2023 May 9;11(5):E446-E450. doi: 10.1055/a-2011-1836. eCollection 2023 May.

Authors

Kurato Miyazaki^{1

2}, Motohiko Kato², Motoki Sasaki², Kentaro Iwata^{1

2}, Teppei Masunaga², Yoko Kubosawa^{1

2}, Yukie Hayashi¹, Mari Mizutani^{1

2}, Yusaku Takatori², Noriko Matsuura², Atsushi Nakayama², Kaoru Takabayashi¹, Kiyokazu Nakajima³, Takanori Kanai¹, Naohisa Yahagi²

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
² Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan.
³ Department of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Osaka, Japan.

Abstract

Background and study aims In esophageal endoscopic submucosal dissection (ESD), the effectiveness of traction including clip-thread method has been reported, but it is difficult to adjust the direction of traction. Therefore, we developed a dedicated over-tube type traction device (ENDOTORNADO) that has a working channel and allows traction from any directions by rotating itself. We investigated the clinical feasibility and potential usefulness of this new device in esophageal ESD. Patients and methods This was a single-center, retrospective study. Six cases of esophageal ESD with ENDOTORNADO from January to March 2022 (tESD group) were compared with 23 cases of conventional esophageal ESD performed by the same operator from January 2019 to December 2021 (cESD group) in terms of clinical treatment outcomes. Results In all cases, en bloc resection was achieved without intraoperative perforation. The total procedure speed was significantly increased in tESD group (23 vs. 30 mm ² /min, P = 0.046). In particular, the submucosal dissection time was significantly reduced to about one-quarter in tESD group (11 vs. 42 min, P = 0.004). Conclusions ENDOTORNADO creates the adjustable traction from any directions and may have the clinical feasibility. It would be an option for human esophageal ESD.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).