AI Article Synopsis

  • Endoscopic submucosal dissection (ESD) in the right colon can be difficult, but using a new flexible grasper with an articulating tip (IgE) can improve the process significantly compared to an earlier version without elbow-like bending (Ig).
  • A study tested both graspers in a synthetic model and a fresh porcine colorectum, finding that IgE could reach all target areas while Ig could not access certain locations.
  • Procedures using IgE resulted in shorter operation times and fewer injuries compared to standard methods, suggesting that IgE is a more effective tool for removing large polyps in the right colon.

Article Abstract

Endoscopic submucosal dissection (ESD) is challenging in the right colon. Traction devices can make it technically easier. In this study, we evaluated a flexible grasper with articulating tip and elbow-like bending (IgE) through a double-balloon surgical platform (DESP), compared with an earlier generation grasper without elbow-like bending (Ig). The reach of Ig/IgE was investigated at eight locations using a synthetic colon within a 3D model. Using a fresh porcine colorectum, 4 cm pseudo-polyps were created at the posterior wall of the ascending colon. Fifty-four ESD procedures were performed using three techniques: standard ESD (STD), ESD using Ig (DESP + Ig), and ESD using IgE (DESP + IgE). IgE was able to reach the full circumference at all the locations, whereas the medial walls proximal to the descending colon were out of Ig's reach. Compared with the STD, both DESP + Ig and DESP + IgE showed significantly shorter procedure time (STD vs. DESP + Ig vs. DESP + IgE = median 48.9 min vs. 38.6 vs. 29.9) and fewer injuries (1.5 vs. 0 vs. 0). Moreover, the DESP + IgE had a shorter procedure time than the DESP + Ig (p = 0.0025). The IgE with DESP increased instrument reach compared to Ig, and likely represented a traction tool for excision of large pseudo-polyps in the right colon.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455611PMC
http://dx.doi.org/10.1038/s41598-021-98162-xDOI Listing

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