Gastric endoscopic submucosal dissection assisted by a new traction method: the clip-band technique. A feasibility study in a porcine model (with video).
BACKGROUND
Endoscopic submucosal dissection (ESD) is the standard of care for treating gastric intramucosal neoplasias in Japan. However, it is seldom performed in Western countries, mainly because it is technically very challenging. Several traction methods have been proposed to facilitate submucosal dissection, but they are usually not widely available or are difficult to apply.


OBJECTIVE
Our main aim was to evaluate the feasibility of a new method, the clip-band technique, for improving the visualization of the submucosal layer during ESD.


METHODS
Observational, experimental, feasibility study conducted in a porcine model.


METHODS
University Hospital of the Canary Islands, Research Animal Laboratory.


METHODS
Animal study.


METHODS
After completion of the circumferential cutting, a clip-band traction system was applied.


METHODS
Efficacy and safety of the clip-band technique.


RESULTS
Eighteen ESDs performed in live domestic pigs were completed without any serious complications. The mean specimen size was 35.38 ± 12.17 mm, the mean cutting time was 13.06 ± 10.52 minutes, and the mean dissection time was 16.67 ± 9.01 minutes.


CONCLUSIONS
The clip-band technique was not compared with the standard ESD technique.


CONCLUSIONS
This initial study shows that the clip-band traction technique is feasible and that it permits safe, effective, and relatively inexpensive gastric ESD.
Endoscopy Unit, Department of Gastroenterology, University Hospital of Canary Islands, Tenerife, Spain. parrablanco@gmail.com
Adolfo
A
Parra-Blanco
David
D
Nicolas
Maria R
MR
Arnau
Antonio Z
AZ
Gimeno-Garcia
Luis
L
Rodrigo
Enrique
E
Quintero
D000818:Animals; D004210:Dissection / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D013552:Swine; D013997:Time Factors