A novel device for endoscopic submucosal dissection, the Fork knife.
OBJECTIVE
To introduce and evaluate the efficacy and technical aspects of endoscopic submucosal dissection (ESD) using a novel device, the Fork knife.


METHODS
From March 2004 to April 2008, ESD was performed on 265 gastric lesions using a Fork knife (Endo FS) (group A) and on 72 gastric lesions using a Flexknife (group B) at a single tertiary referral center. We retrospectively compared the endoscopic characteristics of the tumors, pathological findings, and sizes of the resected specimens. We also compared the en bloc resection rate, complete resection rate, complications, and procedure time between the two groups.


RESULTS
The mean size of the resected specimens was 4.27 +/- 1.26 cm in group A and 4.29 +/- 1.48 cm in group B. The en bloc resection rate was 95.8% (254/265 lesions) in group A and 93.1% (67/72) in group B. Complete ESD without tumor cell invasion of the resected margin was obtained in 81.1% (215/265) of group A and in 73.6% (53/72) of group B. The perforation rate was 0.8% (2/265) in group A and 1.4% (1/72) in group B. The mean procedure time was 59.63 +/- 56.12 min in group A and 76.65 +/- 70.75 min in group B (P < 0.05).


CONCLUSIONS
The Fork knife (Endo FS) is useful for clinical practice and has the advantage of reducing the procedure time.
Kim
Hyun-Gun
HG
Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, College of Medicine, SoonChunHyang University, 657 Hannam-Dong, Yongsan-Gu, Seoul 140-743, South Korea.
Cho
Joo-Young
JY
Bok
Gene-Hyun
GH
Cho
Won-Young
WY
Kim
Wan-Jung
WJ
Hong
Su-Jin
SJ
Ko
Bong-Min
BM
Kim
Jin-Oh
JO
Lee
Joon-Seong
JS
Lee
Moon-Sung
MS
Shim
Chan-Sup
CS
D000368:Aged; D004210:Dissection / Q000295:instrumentation*; D020776:Endoscopes, Gastrointestinal / Q000592:standards*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007267:Injections / Q000295:instrumentation; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000295:instrumentation; D013997:Time Factors