Mapping biopsy for bile duct cancer using a novel device delivery system

Pancreatic duct biopsies using a novel device delivery system for preoperative evaluation of main duct intraductal papillary mucinous neoplasm

“…However, it is often difficult to determine whether a high‐grade IPMN is present at the assumed surgical resection margin based only on imaging findings. We previously reported that the novel system is safe and useful for preoperative mapping biopsy for cholangiocarcinoma 1 . As shown herein, this system also enabled safe pancreatic duct biopsies, which was useful not only for accurate diagnosis but also for determining the appropriate surgical procedure.…”

“…Intraductal ultrasonography showed mural nodules in the defective lesion, but not in the caudal MPD. We performed mapping biopsies from the caudal MPD for negative biopsy and the defect lesion for diagnosis using a novel device delivery system (EndoSheather; Piolax, Kanagawa, Japan), which we had developed, and a forceps with a 1.8 mm diameter cup (Radial Jaw 4P; Boston Scientific, Marlborough, MA, USA) 1 (Fig. 2 and Video S1).…”

Transpapillary gallbladder biopsy using newly designed endoscopic sheath

“…To obtain a histological diagnosis, transpapillary gallbladder biopsy was attempted. A 0.025-inch guidewire (VisiGlide2; Olympus, Tokyo, Japan) was placed in the gallbladder, and a newly designed endoscopic sheath (Endosheather; Piolax Medical Device, Kanagawa, Japan) 1 was inserted without endoscopic sphincterotomy. The sheath could be advanced into the gallbladder very smoothly despite the cystic duct bending (Video S1).…”

Endoscopic ultrasound‐guided covered metal stent deployment through endoscopic tapered sheath preventing bile leakage

“…The duration of the procedure, from dilation to stent deployment, should be reduced, or ideally, eliminated to prevent severe adverse events. To achieve this, we first designed a new technique for covered metal stent deployment using a tapered sheath (EndoSheather; Piolax, Kanagawa, Japan) 5 preventing bile leakage. This device allows fistula dilation and subsequent smooth stent delivery through the indwelling outer‐sheath, which provides a secure route to cross the fistula without any concern.…”