Background and Aims
Effective countertraction is a main challenging issue in endoscopic submucosal dissection
(ESD). Several countertraction methods have been developed to address this issue.
The aim of this study was to compare the efficacy of ESD using a novel simplified
robot, the flexible auxiliary single-arm transluminal endoscopic robot (FASTER), with
a traditional technique.
Methods
This was a prospective, randomized animal study. Forty-eight ESDs in 6 pigs were carried
out at 8 different locations (gastric antrum, gastric body, lower esophagus, and middle
esophagus) by the conventional method (n = 24) and by the FASTER-assisted method (n =
24). The primary outcomes were total procedure time, dissection time, and rate of
direct-vision dissection. Secondary endpoints were completeness of en-bloc resection
and adverse event rate.
Results
The total procedure time was significantly shorter in FASTER-assisted ESD than in
conventional ESD (18.8 vs 32.8 minutes; P < .001). In contrast to the median direct-vision dissection rate of 73% with conventional
ESD, the FASTER-assisted group had a significantly higher rate of 96% (P < .001). The number of sites of muscular damage was significantly lower using the
FASTER-assisted method than the conventional method (6 vs 21, respectively; P = .018). This improvement was more apparent in esophageal lesions compared with gastric
lesions.
Conclusions
This study demonstrated that using a simplified robot during ESD is technically feasible
and enables the endoscopist to dynamically use countertraction. This device could
significantly reduce procedure time compared with conventional ESD techniques.
Abbreviations:
ESD (endoscopic submucosal dissection), FASTER (flexible auxiliary single-arm transluminal endoscopic robot), IQR (interquartile range)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 18, 2022
Accepted:
January 9,
2022
Received:
October 3,
2021
Footnotes
DISCLOSURE: All authors disclosed no financial relationships. Research support for this study was provided by the National Key R&D Program of China (2018YFB1307700), Natural Science Foundation of Shandong Province, China (ZR2020LZL003), Key Research and Development Program of Shandong Province (2018CXGC1209), and Taishan Scholars Program of Shandong Province and National Clinical Research Center for Digestive Diseases supporting technology project (2015BAI13B07).
DIVERSITY, EQUITY, AND INCLUSION: We worked to ensure sex balance in the selection of nonhuman subjects. The author list of this article includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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