Safety and effectiveness of single-channel endoscope multibending-assisted endoscopic submucosal dissection for gastric lesions in difficult locations (with video)
10.3760/cma.j.cn321463-20240109-00009
- VernacularTitle:单腔内镜双弯式用于胃困难部位内镜黏膜下剥离术的安全性及有效性初探（含视频）
- Author:
Zeyu WU
1
;
Lijuan MAO
;
Ting ZHANG
;
Tian JIN
;
Xiaoyun LU
;
Hongna LU
;
Chang'en LIU
;
Xiao HU
;
Qide ZHANG
Author Information
1. 南京中医药大学附属医院 江苏省中医院消化内镜中心，南京 210029
- Keywords:
Gastric neoplasms;
Endoscopic submucosal dissection;
Endoscopic full thickness resection;
Difficult location;
Single-channel scope multibending method
- From:
Chinese Journal of Digestive Endoscopy
2024;41(8):658-662
- CountryChina
- Language:Chinese
-
Abstract:
The gastric fundus fornix and upper part of the gastric body pose challenges for endoscopic submucosal dissection (ESD), resulting in unsatisfactory resection outcomes for lesions in these areas,because of the difficulty in the endoscope reaching the lesion site. Drawing inspiration from the formation of α loop during flexible colonoscopy and double-channel multibending gastroscope, a single-channel treatment gastroscope was utilized to create a multibending state (referred to as single-channel endoscope multibending method, SCMB). This method was employed to treat 6 patients with lesions in the stomach at Digestive Endoscopy Center of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2021 to December 2021. There were 3 cases in the gastric fundus fornix, 2 cases in the greater curvature on the upper part of the gastric body, and 1 case in the posterior wall of gastric fundus and subcardia. After 2-3 attempts during surgery, SCMB was successfully performed in all cases within 60-120 seconds. All 6 cases completed successful endoscopic resection within 20-80 minutes without significant complications, including 4 cases of ESD and 2 cases of endoscopic full-thickness resection (EFR). Preliminary results indicate that SCMB method during ESD and its derivative technologies are both safe and effective for lesions in challenging areas where gastric ESD is difficult to perform. During surgery, this approach facilitates the front end of endoscope access to the lesion, providing a clear visual field and a stable dissection plane.
