Initial experience with Barrett's strip endoscopic mucosal excision: a new Barrett's excision device.
BACKGROUND
Barrett's mucosa resection techniques are time consuming, often difficult to perform, and used with varying success. This report describes the authors' results with a new device and technique for strip endoscopic mucosal resection (SEMR) using a cold excision blade.


METHODS
A retrospective review of ex vivo and in vivo animal and human esophagi experiments was conducted to develop the essential design characteristics of a transoral strip mucosal excision device. Depth, size, shape, and technique of excision were serially evaluated.


RESULTS
The SEMR device allows precise capsule positioning with satisfactory excision size and depth in ex vivo and in vivo experiments. A total of 10 excisions were performed on five normal ex vivo cadaveric human esophagi. The specimens ranged in size from 3×2.5 to 2.5×2.2 cm. The average specimen thickness was 0.297 mm. For 147 (99.8%) of 150 fields of examination, muscularis mucosa was included. Six additional in vivo experiments demonstrated device safety and feasibility.


CONCLUSIONS
Satisfactory excision depth was reproducible. Further animal survival experiments and clinical trials will define the role of the SEMR device for patients with Barrett's esophagus.
Légner
András
A
Department of Surgery, Creighton University School of Medicine, 601 N 30th Street, #3700, Omaha, NE 68131, USA.
Stadlhuber
Rudolf J
RJ
Yano
Fumiaki
F
Tsuboi
Kazuto
K
Mittal
Sumeet K
SK
Rothstein
Richard I
RI
Filipi
Charles J
CJ
D000818:Animals; D001471:Barrett Esophagus / Q000601:surgery; D004285:Dogs; D004867:Equipment Design; D004869:Equipment Safety; D004943:Esophagogastric Junction / Q000601:surgery; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000295:instrumentation* / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D066298:In Vitro Techniques; D009092:Mucous Membrane / Q000601:surgery*; D010215:Papio; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013552:Swine