Clin Endosc > Epub ahead of print
Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection? (with Video)
Yunho Jung1 , Gwang Ho Baik2 , Weon Jin Ko3 , Bong Min Ko4 , Seong Hwan Kim5 , Jin Seok Jang6 , Jae-Young Jang7 , Wan-Sik Lee8 , Young Kwan Cho5 , Sun Gyo Lim9 , Hee Seok Moon10 , In Kyung Yoo11 , Joo Young Cho11
1Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
2Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
3Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
4Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
5Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
6Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
7Department of Gastroenterology and Hepatology, College of Medicine, Kyung Hee University, Seoul, Korea
8Department of Internal Medicine, Chonnam National University Hwasun Hospital, Gwangju, Korea
9Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
10Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
11Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, Seongnam, Korea
Correspondence :  Joo Young Cho ,Tel: +82-31-780-5641, Fax: +82-32-780-5005, Email: cjy6695@naver.com
Received: August 19, 2020  Revised: October 9, 2020   Accepted: October 15, 2020
Abstract

Background/Aims:
A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.
Methods:
In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.
Results:
The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.
Conclusions:
The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.
Key Words: Endoscopic mucosal resection; Hemostasis; Lasers; Perforation
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