Kikuchi Daisuke, Kuribayashi Yasutaka, Iizuka Toshiro, Nomura Kosuke, Kimura Ryusuke, Yamada Akihiro, Yamashita Satoshi, Furuhata Tsukasa, Matsui Akira, Mitani Toshifumi, Ogawa Osamu, Hoteya Shu, Kaise Mitsuru
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Digestion. 2015;91(1):26-9. doi: 10.1159/000368767. Epub 2015 Jan 20.
In many endoscopic procedures, the operative view can be compromised when manipulating the treatment device because the endoscopists must release their hand from the endoscope. We have developed a new device called the Smart Shooter® (SS) for simultaneous manipulation of the endoscope and treatment device, and evaluated the utility of the SS compared with the conventional method.
The SS is a semirigid, loop-shaped channel extender that enables endoscopists to manipulate the treatment device with the thumb of the right hand while holding the endoscope with the same hand. We conducted a comparative study of gastric endoscopic submucosal dissection (ESD) and esophageal injection sclerotherapy (EIS) in a porcine model to compare the utility of the SS method with the conventional method.
In gastric ESD, all lesions were resected en bloc with no perforation. The mean operative time was significantly shorter with the SS method than with the conventional method (287.5 ± 155.4 vs. 403.5 ± 215.6 s, p = 0.04). In esophageal EIS, 4 paravenous injections were given with the SS method and 5 were given using the conventional method. Similarly, the mean operative time was significantly shorter with the SS method than with the conventional method (19.0 ± 7.8 vs. 23.8 ± 10.0 s, p = 0.04).
Use of the SS enabled a shorter operative time for gastric ESD and esophageal EIS with no adverse events. The present results suggest that the SS can contribute to safe and speedy endoscopic treatment.
在许多内镜手术中,当操作治疗设备时,手术视野可能会受到影响,因为内镜医师必须将手从内镜上松开。我们开发了一种名为智能射击器(SS)的新设备,用于同时操作内镜和治疗设备,并评估了SS与传统方法相比的实用性。
SS是一种半刚性的环形通道延长器,使内镜医师能够在用同一只手握住内镜的同时,用右手拇指操作治疗设备。我们在猪模型中对胃内镜黏膜下剥离术(ESD)和食管注射硬化疗法(EIS)进行了一项比较研究,以比较SS方法与传统方法的实用性。
在胃ESD中,所有病变均整块切除,无穿孔。SS方法的平均手术时间明显短于传统方法(287.5±155.4秒对403.5±215.6秒,p = 0.04)。在食管EIS中,SS方法进行了4次静脉旁注射,传统方法进行了5次。同样,SS方法的平均手术时间明显短于传统方法(19.0±7.8秒对23.8±10.0秒,p = 0.04)。
使用SS可缩短胃ESD和食管EIS的手术时间,且无不良事件。目前的结果表明,SS有助于安全、快速地进行内镜治疗。