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...

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Autores principales:	Shinya Urakawa, Teijiro Hirashita, Yuka Hirashita, Lea Lowenfeld, Krishna C. Gurram, Makoto Nishimura, Jeffrey W. Milsom
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0722e99e7cae4ec9af45c814366c44fb
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spelling	oai:doaj.org-article:0722e99e7cae4ec9af45c814366c44fb2021-12-02T17:27:03ZUse of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial10.1038/s41598-021-98162-x2045-2322https://doaj.org/article/0722e99e7cae4ec9af45c814366c44fb2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98162-xhttps://doaj.org/toc/2045-2322Abstract 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.Shinya UrakawaTeijiro HirashitaYuka HirashitaLea LowenfeldKrishna C. GurramMakoto NishimuraJeffrey W. MilsomNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	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_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_sort	use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0722e99e7cae4ec9af45c814366c44fb
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Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial

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