A novel approach to endoscopic colorectal mucosal resection using a three-channel outer tube and multiple forceps: an experimental assessment.
OBJECTIVE
Colorectal endoscopic mucosal resection (EMR) has limitations both anatomically and technically when it is done using the conventional snare wire method. The aim of this study was to develop a new method and instrument for colorectal EMR.


METHODS
A total of 21 EMR procedures were done using ten surgical specimens. Saline was injected into the normal submucosa of freshly resected colorectal specimens to prepare a pseudotumor. EMR was performed experimentally by employing a three-channel outer tube with three forceps and a colonoscope with a needle-type precutting knife. This method was assessed in terms of safety and the size of the resected specimens.


RESULTS
Perforation occurred only twice in the initial stage of this study. The size of the specimens resected by EMR was 28-39 mm (long diameter 34.8+/-3.11), by 22-28 mm (short diameter 25.8+/-2.07).


CONCLUSIONS
This method can achieve safety and en bloc mucosal resection to the submucosal layer. This novel approach may be promising for clinical application as a new form of endoscopic surgery.
Mukai
M
M
Dept. of Surgery, Tokai University Oiso Hospital, Kanagawa, Japan.
Iwase
H
H
Himeno
S
S
Ishii
M
M
Yasuda
S
S
Nakazaki
H
H
Makuuchi
H
H
D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D007413:Intestinal Mucosa / Q000601:surgery*; D013525:Surgical Instruments