Submucosal injection with waterjet improves endoscopic mucosal resection of colorectal adenoma – a randomised controlled clinical trial

Belle, Sebastian; Boscamp, Manuel von; Sold, M.; Mack, Susanne; Pilz, Lothar R.; Ebert, Matthias; Kaehler, Georg

doi:10.1080/00365521.2016.1246606

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…In gastrointestinal applications or for lifting the oral mucosa comparable settings are well established. [8][9][10][11] But the pressure levels required for reaching the urethral sphincter muscle by fluids or microparticles exceeded the pressure levels tolerated by viable cells by far. This is not unexpected, as cells are accelerated at elevated pressure levels in tubing and nozzle, and therefore are disrupted at higher travel velocities.…”

Section: Discussionmentioning

confidence: 99%

“…7 It elevates tissue layers during endoscopic submucosal dissection, that is, the mucosal layer from the submucosa, by injecting a fluid cushion needle-free. [8][9][10][11] We hypothesized that an advanced waterjet technology may deliver not only pure fluid into tissue at specific depths, but also fluid containing commodities, including viable cells. It may reach through epithelial layers, and possibly even deeper to the mucosal and submucosal levels.…”

Section: Introductionmentioning

confidence: 99%

“…The waterjet, for instance, separates liver tissue selectively without injury of blood vessels . It elevates tissue layers during endoscopic submucosal dissection, that is, the mucosal layer from the submucosa, by injecting a fluid cushion needle‐free . We hypothesized that an advanced waterjet technology may deliver not only pure fluid into tissue at specific depths, but also fluid containing commodities, including viable cells.…”

Section: Introductionmentioning

confidence: 99%

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A novel waterjet technology for transurethral cystoscopic injection of viable cells in the urethral sphincter complex

Jäger

Linzenbold

Fech

et al. 2019

Neurourology and Urodynamics

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Aims: In a recent preclinical study, we noticed that injection of cells in the urethral sphincter by needle through a cystoscope under visual control frequently yielded in misplacement or loss of cells. We, therefore, investigated if a needle-free waterjet device delivers viable cells under defined settings, including injection volume and pressure, fluid velocity and transportation media, precisely through the urothelium and connective tissue close to the sphincter muscle without full penetration of the sphincter apparatus. Methods: Mesenchymal stromal cells (MSCs) were prepared for needle-free waterjet injections. Upon injections into liquids cell viability and yield were investigated by trypan blue dye exclusion. Upon injection into cadaveric urethral tissue samples, cells were isolated from the urethrae and expanded to prove that this novel method delivered viable cells into the tissue. MSC injections by William's needle served as controls. Results: Waterjet injections of MSCs into isotonic cell culture medium resulted in equal or better yields of viable cells when compared with needle injections.Upon injection in urethral tissue samples, the waterjet technology facilitated fast and precise injections of viable cells through urothelial, mucosal and submucosal layers to reach the sphincter muscle. By controlling the injection pressure, loss of cells due to insufficient thrust or unintended full penetration was avoided.Conclusions: Needle-free waterjet injections deliver cells in the urethra faster and more precisely when compared with needle injections without compromising their viability. This is the first proof-of-concept study providing evidence that a waterjet transports viable cells precisely into the targeted tissue. K E Y W O R D S cell injection, cell therapy, medical technology, stress urinary incontinence, waterjet ---This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Abbreviations: E, effect = pump setting, reflects a given pressure in an open system; IPCM, improved pressure control mode; LSM, laser scanning microscope; MSC, mesenchymal stromal cells; SUI, stress urinary incontinence; UPaCS, upgraded pump and controller system (based on ERBEJET 2).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A novel waterjet technology for transurethral cystoscopic injection of viable cells in the urethral sphincter complex

Jäger

Linzenbold

Fech

et al. 2019

Neurourology and Urodynamics

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“…Injections are performed using an injection needle at one or multiple sites around the lesion. Recently, a needleless injection using an automated pump has been made commercially available [18].…”

Section: Techniques Of Endoscopic Mucosal Resectionmentioning

confidence: 99%

Endoscopic Resection Techniques

Hoffman¹,

Heesen²,

Kollmar³

et al. 2017

Visc Med

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“…Hierbei wird der Befund mit Kochsalz-und Adrenalinlösung unterspritzt, um eine Distanzierung der Neoplasie von der Muscularis propria zu erzielen und das Blutungsrisiko zu vermindern. Mit dieser Technik können auch sehr große Adenome effektiv abgetragen werden [2].…”

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Endoskopisches Management von kolorektalen Adenomen, HGIEN und Frühkarzinomen

Kolligs¹

2020

Onkologie up2date

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ZusammenfassungNeben ihrem diagnostischen Potenzial erlaubt die Koloskopie auch die endoskopische Resektion von Polypen und Frühkarzinomen. Mit der konventionellen Schlingenresektion, der endoskopischen Mukosaresektion (EMR), der endoskopische Submukosadissektion (ESD) und neuerdings der endoskopischen Vollwandresektion (eFTR) stehen verschiedenene intraluminale Resektionsverfahren zur Verfügung, die in diesem Artikel vorgestellt werden.

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Submucosal injection with waterjet improves endoscopic mucosal resection of colorectal adenoma – a randomised controlled clinical trial

Abstract: This study demonstrated that the new STEP technique leads to a higher rate of en-bloc resections than the standard injection technique in endoscopic mucosa resection of colorectal adenomas. The STEP technique can play an important role in the future of EMR.

Cited by 6 publications

References 15 publications

A novel waterjet technology for transurethral cystoscopic injection of viable cells in the urethral sphincter complex

A novel waterjet technology for transurethral cystoscopic injection of viable cells in the urethral sphincter complex

Endoscopic Resection Techniques

Endoskopisches Management von kolorektalen Adenomen, HGIEN und Frühkarzinomen

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