Akahoshi K, Akahane H, Murata A, Akiba H, Oya M
Department of Gastroenterology, Aso Iizuka Hospital, Iizuka, Japan.
Endoscopy. 2007 Dec;39(12):1103-5. doi: 10.1055/s-2007-966842.
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure that is associated with a high complication rate. The shortcoming of this method is the difficulty in fixing the knife to the target lesion. This difficulty can lead to unexpected incision, resulting in major complications such as perforation and bleeding. To reduce the risk of complications related to ESD, we developed a new grasping type scissors forceps (GSF), which can grasp and incise the targeted tissue using an electrosurgical current. The ESD procedure using the GSF was carried out in an animal model (resected porcine stomachs in vitro). After marking the lesion and injecting a solution into the submucosa, the lesion was separated from the surrounding normal mucosa following complete incision around the lesion using the GSF. A piece of submucosal tissue was grasped and cut with the GSF using an electrosurgical current to achieve submucosal exfoliation. ESD using the GSF was carried out safely and easily without unintentional incision. ESD using GSF appears to be an easy, safe, and technically efficient method for resecting gastrointestinal neoplasms.
使用刀具进行内镜黏膜下剥离术(ESD)是一项技术要求很高的操作,且并发症发生率较高。该方法的缺点是难以将刀具固定在目标病变处。这一困难可能导致意外切割,引发诸如穿孔和出血等严重并发症。为降低与ESD相关的并发症风险,我们研发了一种新型抓持式剪刀钳(GSF),它可利用电外科电流抓持并切割目标组织。使用GSF的ESD操作在动物模型(体外切除的猪胃)中进行。在标记病变并向黏膜下层注射溶液后,使用GSF在病变周围完全切开,将病变与周围正常黏膜分离。用GSF通过电外科电流抓持并切割一片黏膜下组织,以实现黏膜下剥离。使用GSF进行ESD操作安全简便,不会出现意外切割。使用GSF进行ESD似乎是一种切除胃肠道肿瘤的简便、安全且技术高效的方法。