title: Endoscopic cell sheet transplantation device developed by using a 3-dimensional printer and its feasibility evaluation in a porcine model.
abstract: BACKGROUND
  To prevent severe esophageal stenosis after aggressive endoscopic submucosal dissection (ESD), our group previously reported an efficient treatment using cell sheets that had been fabricated from patient cells. However, this transplantation procedure had not been easy for every endoscopist and needed to be improved to derive the full effect of epithelial cell sheets.
  
  
  OBJECTIVE
  To develop an endoscopic device that enables easy and effective cell sheet transplantation and to evaluate its performance and clinical feasibility.
  
  
  METHODS
  Animal study.
  
  
  METHODS
  Animal experimentation laboratory.
  
  
  METHODS
  Three pigs underwent circumferential esophageal ESD while under general anesthesia. A total of 12 cell sheets were endoscopically transplanted to the ESD site; 6 cell sheets were transplanted by using an endoscopic device that we developed, and 6 cell sheets were transplanted by using the conventional method.
  
  
  METHODS
  Procedure time, transplanted area on the ESD site, transplantation success rate, and monitoring of adverse events or incidents.
  
  
  RESULTS
  The device allowed successful transplantation of all cell sheets with a shorter procedure time than with the conventional method (4.8 ± 0.8 minutes vs 13.3 ± 5.7 minutes, respectively) (P = .005) and onto a larger area (111.3 ± 56.3 mm(2) vs 41.8 ± 4.2 mm(2), respectively) (P = .023) with a higher success rate (100% vs 83%, respectively). No adverse incidents were monitored in each method.
  
  
  CONCLUSIONS
  Animal study, small sample.
  
  
  CONCLUSIONS
  A newly designed endoscopic cell sheet transplantation device would be useful.
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kanai
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Pharmaceutical Sciences, Graduate school of Pharmaceutical Science, Tokyo University of Science, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hosoi
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagi
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohki
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan; Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamato
authors.affiliation: Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.affiliation: Department of Pharmaceutical Sciences, Graduate school of Pharmaceutical Science, Tokyo University of Science, Tokyo, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Fukai
authors.affiliation: Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
mesh_terms: D000818:Animals; D004940:Esophageal Stenosis / Q000209:etiology / Q000517:prevention & control*; D016629:Esophagectomy / Q000379:methods; D004945:Esophagoscopy / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation*; D011183:Postoperative Complications / Q000517:prevention & control*; D066330:Printing, Three-Dimensional; D013552:Swine; D023822:Tissue Engineering / Q000379:methods