Gastric endoscopic submucosal dissection assisted by a new traction method: the clip-band technique. A feasibility study in a porcine model (with video)

Parra-Blanco, Adolfo; Nicolas, David; Arnau, Maria R.; Gimeno-Garcia, Antonio Z.; Rodrigo, Luis; Quintero, Enrique

doi:10.1016/j.gie.2011.07.037

« Previous Next »Gastrointestinal Endoscopy
Volume 74, Issue 5 , Pages 1137-1141, November 2011

Gastric endoscopic submucosal dissection assisted by a new traction method: the clip-band technique. A feasibility study in a porcine model (with video)

Presented at Digestive Disease Week 2010, New Orleans, LA, May 1-5, 2010 (Gastrointest Endosc 2010;71:AB321).

Adolfo Parra-Blanco, MD, PhD
- Endoscopy Unit, Department of Gastroenterology, University Hospital of the Canary Islands, Tenerife, Spain
- Endoscopy Unit, Department of Gastroenterology, Asturias Central University Hospital, Oviedo, Spain
- Reprint requests: Adolfo Parra-Blanco, MD, PhD, Endoscopy Unit, Hospital Universitario Central de Asturias, Celestino Villamil s/n, 33006 Oviedo, Principado de Asturias, Spain
David Nicolas, MD, PhD
- Endoscopy Unit, Department of Gastroenterology, University Hospital of the Canary Islands, Tenerife, Spain
Maria R. Arnau, DVM, PhD
- Research Animal Laboratory, La Laguna University, Tenerife, Spain
Antonio Z. Gimeno-Garcia, MD, PhD
- Endoscopy Unit, Department of Gastroenterology, University Hospital of the Canary Islands, Tenerife, Spain
Luis Rodrigo, MD, PhD
- Endoscopy Unit, Department of Gastroenterology, Asturias Central University Hospital, Oviedo, Spain
Enrique Quintero, MD, PhD
- Endoscopy Unit, Department of Gastroenterology, University Hospital of the Canary Islands, Tenerife, Spain

Received 7 February 2011; accepted 16 July 2011.

Background

Endoscopic submucosal dissection (ESD) is the standard of care for treating gastric intramucosal neoplasias in Japan. However, it is seldom performed in Western countries, mainly because it is technically very challenging. Several traction methods have been proposed to facilitate submucosal dissection, but they are usually not widely available or are difficult to apply.

Objective

Our main aim was to evaluate the feasibility of a new method, the clip-band technique, for improving the visualization of the submucosal layer during ESD.

Design

Observational, experimental, feasibility study conducted in a porcine model.

Setting

University Hospital of the Canary Islands, Research Animal Laboratory.

Patients

Animal study.

Interventions

After completion of the circumferential cutting, a clip-band traction system was applied.

Main Outcome Measurements

Efficacy and safety of the clip-band technique.

Results

Eighteen ESDs performed in live domestic pigs were completed without any serious complications. The mean specimen size was 35.38 ± 12.17 mm, the mean cutting time was 13.06 ± 10.52 minutes, and the mean dissection time was 16.67 ± 9.01 minutes.

Limitations

The clip-band technique was not compared with the standard ESD technique.

Conclusions

This initial study shows that the clip-band traction technique is feasible and that it permits safe, effective, and relatively inexpensive gastric ESD.

Abbreviation: ESD, endoscopic submucosal dissection