A novel magnetic countertraction device for endoscopic submucosal dissection significantly reduces procedure time and minimizes technical difficulty

Abstract

Background and study aims In endoscopic submucosal dissection (ESD), effective countertraction may overcome the current drawbacks of longer procedure times and increased technical demands. The objective of this study was to compare the efficacy of ESD using a novel magnetic countertraction device with that of the traditional technique. Methods Each ESD was performed on simulated gastric lesions of 30mm diameter created at five different locations. In total, 10 ESDs were performed using this novel device and 10 were performed by the standard technique. Results The magnetic countertraction device allowed directional tissue manipulation and exposure of the submucosal space. The total procedure time was 605 ± 303.7 seconds in the countertraction group vs. 1082 ± 515.9 seconds in the control group (P=0.021). Conclusions This study demonstrated that using a novel magnetic countertraction device during ESD is technically feasible and enables the operator to dynamically manipulate countertraction such that the submucosal layer is visualized directly. Use of this device significantly reduced procedure time compared with conventional ESD techniques.

Electromagnetic assisted endoscopic submucosal dissection is more efficient than water-jet assisted and conventional ESD in experimental model

“…1a ). There is only one study focused on comparing MG-ESD and conventional ESD, which found results similar to ours 8 . Unfortunately, the authors did not include information on any outcomes concerning adverse events.…”

“…Despite these promising preliminary results, there is only one comparative study in an ex vivo gastric model, of conventional ESD (ESD) versus MG-ESD. This study shows how MG-ESD is more efficient than ESD, and equivalent in terms of safety 8 . On the other hand, waterjet-assisted ESD consists of pressure-controlled injection of fluids through the tip of a waterjet knife.…”

“…In terms of safety, our results are in agreement with those of Gotoda et al 7 in human cases. Regarding technical features, in the comparative study performed by Aihara et al 8 , a double channel endoscope was necessary in order to anchor the magnet at two different points. However, from our point of view, the device could work just using one anchorage point, and therefore, the procedure would be easier to carry out.…”

Endoscopic Submucosal Tunnel Dissection for Large Gastric Neoplastic Lesions: A Case-Matched Controlled Study

“…Several traction methods for ESD have been investigated to overcome the problem, such as percutaneous traction [ 5 ], clip with line [ 6 – 8 ], clip-and-snare [ 9 ], external grasping forceps [ 10 ], internal traction [ 11 , 12 ], suture-pulley [ 13 ], magnetic anchor [ 14 ], double-channel endoscope [ 15 ], double-endoscope [ 16 ], and robot-assisted method [ 17 ]. However, those traction methods need extra devices or equipment and may be invasive or difficult to control the pulley strength and direction or inconvenient to be operated.…”

Magnetic anchor-guided endoscopic submucosal dissection of rectal submucosal tumor in difficult location

“…A thin intestinal muscle layer, poor endoscopic operability and submucosal visual field insufficiency will all increase the risk of complications [1,2]. Magnetic anchor guided ESD (MAG-ESD) provides adequate direction and degrees of traction in various locations, which effectively improves the surgical field of vision [3,4].…”