Chung Hyunsoo, Dhumane Parag, Liu Keng-Hao, Donatelli Gianfranco, Dallemagne Bernard, Marescaux Jacques
1IRCAD, University of Strasbourg, Strasbourg, France.
Surg Innov. 2014 Feb;21(1):5-10. doi: 10.1177/1553350613495980. Epub 2013 Aug 12.
Endoscopic submucosal dissection (ESD) is a technically challenging procedure in which complications and operative times depend on the operator's expertise as well as on the location and size of the lesion. Good visualization of the submucosal dissection plane is essential to perform a safe and effective ESD.
To evaluate the feasibility, efficacy, and safety of a novel traction method using an over-the-scope steerable grasper to improve the exposure of the dissection plane during gastric ESD.
A total of 24 ESDs were performed without any complications in various locations of porcine stomachs, including antrum, gastric body, and cardia. En bloc complete resections were achieved in all cases. The mean specimen size was 44.92 ± 8.30 mm, mean total procedure time was 29.17 ± 11.27 minutes, and mean dissection time was 15.08 ± 7.21 minutes. The optimal dissection plane could be obtained by controlling the grasper in all cases.
Technical feasibility, efficacy, and safety of the over-the-scope steerable grasper technique were demonstrated in order to provide dynamic and controlled traction during ESD at different locations of porcine stomachs.
内镜黏膜下剥离术（ESD）是一项技术要求较高的手术，其并发症和手术时间取决于术者的专业技能以及病变的位置和大小。清晰观察黏膜下剥离平面对于安全有效地进行ESD至关重要。
评估一种使用经内镜可转向抓钳的新型牵引方法在胃ESD期间改善剥离平面暴露的可行性、有效性和安全性。
在猪胃的不同部位（包括胃窦、胃体和贲门）共进行了24例ESD，均无并发症发生。所有病例均实现整块完整切除。标本平均大小为44.92±8.30毫米，平均总手术时间为29.17±11.27分钟，平均剥离时间为15.08±7.21分钟。所有病例均可通过控制抓钳获得最佳剥离平面。
经内镜可转向抓钳技术的技术可行性、有效性和安全性得到了证实，以便在猪胃不同部位的ESD期间提供动态可控的牵引。
