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The Efficacy of an Endoscopic Grasp-and-Traction Device for Gastric Endoscopic Submucosal Dissection: An Ex Vivo Comparative Study (with Video)
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Dirk W. Schölvinck, Osamu Goto, Jacques J. G. H. M. Bergman, Naohisa Yahagi, Bas L. A. M. Weusten
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Clin Endosc 2015;48(3):221-227. Published online May 29, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.3.221
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 Abstract
 PDF Supplementary Material PubReader ePub
- Background/Aims
To investigate whether the EndoLifter (Olympus), a counter-traction device facilitating submucosal dissection, can accelerate endoscopic submucosal dissection (ESD). MethodsTwo endoscopists (novice/expert in ESD) performed 64 ESDs (artificial 3-cm lesions) in 16 ex vivo pig stomachs: per stomach, two at the posterior wall (forward approach) and two at the lesser curvature (retroflex approach). Per approach, one lesion was dissected with (EL+) and one without (EL-) the EndoLifter. The submucosal dissection time (SDT), corrected for specimen size, and the influence of ESD experience on EndoLifter usefulness were assessed. ResultsEn bloc resection rate was 98.4%. In the forward approach, the median SDT was shorter with the EndoLifter (0.56 min/cm2 vs. 0.91 min/cm2), although not significantly (p=0.09). The ESD-experienced endoscopist benefitted more from the EndoLifter (0.45 [EL+] min/cm2 vs. 0.68 [EL-] min/cm2, p=0.07) than the ESD-inexperienced endoscopist (0.77 [EL+] min/cm2 vs. 1.01 [EL-] min/cm2, p=0.48). In the retroflex approach, the median SDTs were 1.06 (EL+) and 0.48 (EL-) min/cm2 (p=0.16). The EndoLifter did not shorten the SDT for the ESD-experienced endoscopist (0.68 [EL+] min/cm2 vs. 0.68 [EL-] min/cm2, p=0.78), whereas the ESD-inexperienced endoscopist seemed hindered (1.65 [EL+] min/cm2 vs. 0.38 [EL-] min/cm2, p=0.03). ConclusionsIn gastric ESD, the EndoLifter, in trend, shortens SDTs in the forward, but not in the retroflex approach. Given the low numbers in this study, a type II error cannot be excluded.
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Citations
Citations to this article as recorded by  - Endoscopic Submucosal Dissection Facilitating Techniques Among Non-experts: A Systematic Literature Review
Kavel Visrodia, Akira Dobashi, Fateh Bazerbachi, John Poneros, Amrita Sethi
Digestive Diseases and Sciences.2023; 68(6): 2561. CrossRef - Endoscopic mucosal resection and endoscopic submucosal dissection with an external additional working channel (EMR+ and ESD+) are equivalent to using a double-channel endoscope: a systematic evaluation in a porcine ex vivo model
Richard F. Knoop, Ahmad Amanzada, Golo Petzold, Volker Ellenrieder, Michael Engelhardt, Albrecht Neesse, Sebastian C. B. Bremer, Steffen Kunsch
Surgical Endoscopy.2023; 37(10): 7749. CrossRef - Endoskopische Resektion von Frühkarzinomen im Gastrointestinaltrakt
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Der Gastroenterologe.2022; 17(2): 109. CrossRef - Endoscopic submucosal dissection with an additional working channel (ESD+): a novel technique to improve procedure time and safety of ESD
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Yutaka Saito, Kazuki Sumiyama, Philip Wai-yan CHIU
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Samuel Han, Andrew Hsu, Wahid Y. Wassef
Current Opinion in Gastroenterology.2016; 32(6): 492. CrossRef - Is the Endoscopic Grasp-and-Traction Device Useful for Endoscopic Submucosal Dissection in Treating Early Gastric Cancer?
Joo Young Cho
Clinical Endoscopy.2015; 48(3): 181. CrossRef
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