A novel viscous dissecting gel for endoscopic submucosal dissection: a prospective survival study in a porcine model.
OBJECTIVE
Endoscopic submucosal dissection (ESD) is a technically challenging procedure. A novel gel can facilitate ESD due to its submucosal dissecting properties. This prospective porcine survival study evaluated clinical and histologic parameters of hybrid ESD using the gel.


METHODS
Gastric submucosal lesions were created in six pigs and hybrid ESD was performed. Healing was assessed weekly until necropsy at Day 28.


RESULTS
En bloc resection was achieved in all lesions (mean size 40.7 mm). The mean total procedure time was 13.5 minutes and the mean resection time was 5.5 minutes. The mean total histologic injury score was 4. At necropsy, four ulcers had healed completely and two were < 6 mm in size.


CONCLUSIONS
Hybrid ESD of large gastric lesions in a porcine model can be facilitated by the novel gel, dramatically reducing procedure and resection times by eliminating the need for time-consuming submucosal dissection. The novel gel is safe and easy to use, and has the potential to simplify ESD. Further prospective human studies are needed to validate these findings.
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Payal
P
Saxena
Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USS.
Brian W
BW
Simons
Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USS.
Kathleen
K
Gabrielson
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Yamile
Y
Haito-Chavez
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ali Kord
AK
Valeshabad
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Vivek
V
Kumbhari
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Vikesh K
VK
Singh
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Anne Marie
AM
Lennon
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Marcia Irene
MI
Canto
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Pankaj J
PJ
Pasricha
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Anthony
A
Kalloo
Department of Medicine and Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Mouen A
MA
Khashab
D000818:Animals; D004210:Dissection / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D005782:Gels; D061646:Operative Time; D011446:Prospective Studies; D016019:Survival Analysis; D034421:Sus scrofa; D014945:Wound Healing
D005782:Gels