Thermoresponsive aerification and tissue vacuolization for facilitating endoscopic submucosal resection

Abstract

Bioinert DDFP was feasible, efficient, and safe as the novel submucosal lifting candidate.

Novel submucosal injection solution 0.6% sodium alginate: Bench to market for endoscopic submucosal dissection optimization

“…Various injection solutions are widely used to facilitate en bloc resection or to reduce the risks of adverse events associated with ESD, in particular, perforation. [3][4][5] Although no consensus for an ideal solution in ESD exists, it should maintain a long-lasting mucosal cushion, be non-toxic and have no influence on the histological evaluation, be inexpensive, be readily available and easily given with optimum injectability. [3][4][5] Sodium hyaluronate (SH) and glycerol solutions are most commonly used to carry out ESD in Japan.…”

“…Rheological properties, viscosity, and osmolality of the injection materials should be experimentally explored ex vivo and hopefully in vivo in addition to electrical assessments to further support their safety. 4,5 In conclusion, sustained submucosal expansion is vital for ESD, given that it is commonly carried out in the thinnerwalled esophagus and colon worldwide, particularly in Western countries. Endoscopists around the world hope that 0.6% SA solution will be officially approved as soon as possible and that its application may expand to colonic endoscopic resections or even to other third space endoluminal interventions.…”

“…In fact, procedural safety increases with greater tissue elevation, and efficiency increases with longer‐lasting submucosal cushion. Various injection solutions are widely used to facilitate en bloc resection or to reduce the risks of adverse events associated with ESD, in particular, perforation …”

“…Although no consensus for an ideal solution in ESD exists, it should maintain a long‐lasting mucosal cushion, be non‐toxic and have no influence on the histological evaluation, be inexpensive, be readily available and easily given with optimum injectability . Sodium hyaluronate (SH) and glycerol solutions are most commonly used to carry out ESD in Japan.…”

“…With respect to muscular damage due to electrification, the electric circuit that forms between the electrode and the tissue can be affected by many variables, influencing the outcome of the procedure. Rheological properties, viscosity, and osmolality of the injection materials should be experimentally explored ex vivo and hopefully in vivo in addition to electrical assessments to further support their safety …”