title: In vitro assessment of the performance of a new multiband mucosectomy device for endoscopic resection of early upper gastrointestinal neoplasia.
abstract: OBJECTIVE
  Multiband mucosectomy (MBM) is widely used for the endoscopic resection of early neoplasia in the upper gastrointestinal tract. A new MBM-device may have advantages over the current MBM-device with improved visualization, easier passage of accessories, and higher suction power due to different trip wire and cap.
  
  
  METHODS
  Rubber bands were released one by one for both MBM-devices while endoscopic images were collected. First, free endoscopic view was assessed by computer-assisted measurements (quantitative) and by ranking the images by a panel of 11 endoscopists (qualitative). Second, using a visual analog scale, three 'blinded' endoscopists assessed introduction and advancement of three types of endoscopic devices through the working channel of a diagnostic endoscope with the MBM-devices assembled. Third, suction power was evaluated by a manometer attached to the cap of the assembled MBM-devices in four endoscopes. Negative pressures were measured after 5 and 10 s of suction and repeated five times. The passage and suction experiments were performed with dry trip wires and repeated after soaking with bloody, mucous fluids.
  
  
  RESULTS
  With all bands present, endoscopic views were 90 and 40% in the new and current MBM-device, respectively. With the release of more bands, differences slowly disappeared. The panel scored a better endoscopic view in the new MBM-device (p = 0.03). Passage of all accessories was considered significantly easier in the new MBM-device. With the associated snare in the working channel, suction power was significantly better with the new MBM-device.
  
  
  CONCLUSIONS
  Compared to the currently available MBM-device, the new MBM-device provides improved endoscopic visibility, smoother passage of accessories, and higher suction power.
authors.affiliation: Department of Gastroenterology and Hepatology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands. d.scholvink@antoniusziekenhuis.nl.|Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. d.scholvink@antoniusziekenhuis.nl.
authors.forename: D W
authors.initials: DW
authors.lastname: Schölvinck
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Belghazi
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R E
authors.initials: RE
authors.lastname: Pouw
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: W L
authors.initials: WL
authors.lastname: Curvers
authors.affiliation: Department of Gastroenterology and Hepatology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.|Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: B L A M
authors.initials: BLAM
authors.lastname: Weusten
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: J J G H M
authors.initials: JJGHM
authors.lastname: Bergman
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal; D005240:Feasibility Studies; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D009092:Mucous Membrane / Q000473:pathology* / Q000601:surgery; D013396:Suction; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000473:pathology*
keywords: Endoscopic resection; Esophageal neoplasia; Gastric neoplasia; Multiband mucosectomy