High-pressure injection of glycerol with HybridKnife for ESD is feasible and increases the ease and speed of the procedure: an in vivo study in pigs and first use in human

Jacques, J.; Sautereau, Denis; Carrier, Paul; Couquet, Claude; Debette‐Gratien, Maryline; Le-Sidaner, Anne; Tabouret, Tessa; Valgueblasse, Virginie; Loustaud‐Ratti, Véronique; Legros, Romain

doi:10.1007/s00464-015-4072-6

Cited by 10 publications

(14 citation statements)

References 12 publications

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“…This may be partially due to our level of expertise clearly increasing in the last years, but also to the Enki-2 itself. Water jet systems proved to be safer with lower perforation rates than conventional knives in animal studies using both Hybrid Knife Ò and Enki-2 Ò [1,2,12,13]. The better mucosal cushion obtained, the simplicity of use by avoiding repeated tool exchange resulting in shorter procedure time and the ability to inject and safely dissect may well explain this null perforation rate.…”

Section: Discussionmentioning

confidence: 96%

Endoscopic submucosal dissection with the Nestis® jet injector system with a bifunctional catheter: first prospective clinical trial (NCT: 2012-A00272-41)

et al. 2016

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Section: Discussionmentioning

confidence: 96%

Endoscopic submucosal dissection with the Nestis® jet injector system with a bifunctional catheter: first prospective clinical trial (NCT: 2012-A00272-41)

et al. 2016

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“…The en bloc resection rate was 100% without any pinholes in the resected specimens. The median procedure time (interquartile range) was 483. ber of injections also decreased, the extent was not statistically significant (median [range] 13 [9][10][11][12][13][14][15] vs. 10.5 [8][9][10][11][12][13][14][15] vs. 9.5 [4][5][6][7][8][9][10][11][12][13][14], p = 0.164).…”

Section: Study Outcomesmentioning

confidence: 96%

“…In addition, this knife comes with a water-jet function and a balltip on the distal side similar to the conventional needletype knife, which was reported to improve the efficiency of the ESD procedure [7,13,14]. High-pressure submucosal injection using the water-jet function can be performed with the Endosaber without the need for any other injection needle [13,15]. The ball-tip helps to control the incision and hemostasis.…”

Section: Introductionmentioning

confidence: 99%

Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study

et al. 2019

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Background: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. Methods: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. Results: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399–619.3) s (median incision time: 240.4 [168.3–332.5] s; median dissection time: 222 [182.8–257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9–14.3). The procedure time decreased significantly with increase in experience (p = 0.020). Conclusions: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans.

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“…nearly 40 % speed gain with the Hybrid Knife [8]. It is important to be familiar with the equipment you are working with because the roller pump systems used for the Dual Knife Jet (Olympus), Flush Knife (FujifilMm), Splash M Knife (Pentax), and the Orise Proknife (Boston) are not dedicated to the injection of viscous solutions, although experience shows that use of low-viscous solutions, such as glycerol or hydroxyethylstarch, may be possible.…”

Section: E1723mentioning

confidence: 99%

Endoscopic submucosal dissection: How to be more efficient?

et al. 2021

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Endoscopic submucosal dissection (ESD) allows an “en bloc” resection with safety margins (R0 resection) regardless of the size of the lesion. However, while R0 brings a real benefit for the patient, it is not considered sufficient by many experts to justify the technical difficulties and the longer procedure time compared to piecemeal mucosectomy. The aims of this review are to provide several technical and strategical tips to help you save time and become comfortable during ESD procedures. ESD is divided into several intertwined phases: injection, incision, access to the submucosae, and submucosal dissection itself. During injection there are some mistakes that should not be made: a superficial injection, or on the contrary, a too deep injection. A good needle and good injection technique are mandatory. Some techniques, such as repeated injection or prolonged lifting solution, can help maintain the lift. After this step, mucosal incision can be made, taking care to have a good margin to allow an R0 resection. Starting the mucosal incision from a small point allows calibration of the depth of the incision and then obtaining a nice incision. Trimming is also very important to widen submucosal access. Then comes the submucosal dissection itself. Strategies such as the tunnel strategy or the pocket creation method can help to facilitate dissection, but more importantly, traction systems have become unavoidable, especially in the stomach and colon. Most common complications are bleeding and perforation, and they usually can be managed endoscopically.

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High-pressure injection of glycerol with HybridKnife for ESD is feasible and increases the ease and speed of the procedure: an in vivo study in pigs and first use in human

Abstract: High-pressure jet injection of glycerol with HybridKnife for ESD is feasible and increases the speed and safety of the procedure compared with use of normal saline.

Cited by 10 publications

References 12 publications

Endoscopic submucosal dissection with the Nestis® jet injector system with a bifunctional catheter: first prospective clinical trial (NCT: 2012-A00272-41)

Endoscopic submucosal dissection with the Nestis® jet injector system with a bifunctional catheter: first prospective clinical trial (NCT: 2012-A00272-41)

Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study

Endoscopic submucosal dissection: How to be more efficient?

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