Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial
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 ea...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2021-09-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-98162-x |
| _version_ | 1818343286917562368 |
|---|---|
| author | Shinya Urakawa Teijiro Hirashita Yuka Hirashita Lea Lowenfeld Krishna C. Gurram Makoto Nishimura Jeffrey W. Milsom |
| author_facet | Shinya Urakawa Teijiro Hirashita Yuka Hirashita Lea Lowenfeld Krishna C. Gurram Makoto Nishimura Jeffrey W. Milsom |
| author_sort | Shinya Urakawa |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T16:28:11Z |
| format | Article |
| id | doaj.art-0722e99e7cae4ec9af45c814366c44fb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-13T16:28:11Z |
| publishDate | 2021-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-0722e99e7cae4ec9af45c814366c44fb2022-12-21T23:38:34ZengNature PortfolioScientific Reports2045-23222021-09-011111910.1038/s41598-021-98162-xUse of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trialShinya Urakawa0Teijiro Hirashita1Yuka Hirashita2Lea Lowenfeld3Krishna C. Gurram4Makoto Nishimura5Jeffrey W. Milsom6Department of Surgery, Weill Cornell Medicine/ New York Presbyterian HospitalDepartment of Surgery, Weill Cornell Medicine/ New York Presbyterian HospitalDepartment of Surgery, Weill Cornell Medicine/ New York Presbyterian HospitalDepartment of Surgery, Weill Cornell Medicine/ New York Presbyterian HospitalDepartment of Gastroenterology and Hepatology, The Brooklyn Hospital CenterGastroenterology, Hepatology and Nutrition Service, Memorial Sloan Kettering Cancer CenterDepartment of Surgery, Weill Cornell Medicine/ New York Presbyterian HospitalAbstract 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.https://doi.org/10.1038/s41598-021-98162-x |
| spellingShingle | Shinya Urakawa Teijiro Hirashita Yuka Hirashita Lea Lowenfeld Krishna C. Gurram Makoto Nishimura Jeffrey W. Milsom Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial Scientific Reports |
| title | Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial |
| title_full | Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial |
| title_fullStr | Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial |
| title_full_unstemmed | Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial |
| title_short | Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial |
| title_sort | use of an endoscopic flexible grasper as a traction tool for excision of polyps preclinical trial |
| url | https://doi.org/10.1038/s41598-021-98162-x |
| work_keys_str_mv | AT shinyaurakawa useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT teijirohirashita useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT yukahirashita useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT lealowenfeld useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT krishnacgurram useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT makotonishimura useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial AT jeffreywmilsom useofanendoscopicflexiblegrasperasatractiontoolforexcisionofpolypspreclinicaltrial |