BACKGROUND: The advent of natural orifice transluminal endoscopic surgery (NOTES) has accelerated the development of new technology in the field of GI endoscopy. Various suturing devices or multitasking platforms are expected to be valuable for endoluminal surgery as well as for NOTES. OBJECTIVE: To evaluate a new multitasking platform in performing endoscopic full-thickness resection (EFTR). DESIGN: Bench-top comparison study. SETTING: Research laboratory study of 10 ex vivo porcine models. INTERVENTION: Ten EFTRs (5 with a double-channel endoscope vs 5 with a new multitasking platform) assisted with percutaneous gastric lifting. Each group was given the task of resecting a full-thickness specimen of the gastric wall including a pseudolesion 10 mm in diameter with an effective margin. MAIN OUTCOME MEASUREMENTS: Outcome measurements included time to perform the procedure, accuracy of the resection, and efficiency for the task. Accuracy was assessed according to variability of the surgical margin and misalignment between the mucosal layer and the seromuscular layer. Efficiency was assessed according to the duty ratio, which is the percentage of time spent for the main purposes compared with the total procedure time. RESULTS: Mean diameter of the specimen was not significantly different between the groups. All other assessment items were significantly superior in group B to those in group A (P < .05). LIMITATIONS: Ex vivo animal model study. CONCLUSION: We were able to perform EFTR procedures precisely and effectively by using a new multitasking platform compared with use of a conventional endoscope in a porcine model. A multitasking platform developed for NOTES procedures would be useful for advanced endoluminal surgery such as endoscopic submucosal dissection or EFTR as well as NOTES.
BACKGROUND: The advent of natural orifice transluminal endoscopic surgery (NOTES) has accelerated the development of new technology in the field of GI endoscopy. Various suturing devices or multitasking platforms are expected to be valuable for endoluminal surgery as well as for NOTES. OBJECTIVE: To evaluate a new multitasking platform in performing endoscopic full-thickness resection (EFTR). DESIGN: Bench-top comparison study. SETTING: Research laboratory study of 10 ex vivo porcine models. INTERVENTION: Ten EFTRs (5 with a double-channel endoscope vs 5 with a new multitasking platform) assisted with percutaneous gastric lifting. Each group was given the task of resecting a full-thickness specimen of the gastric wall including a pseudolesion 10 mm in diameter with an effective margin. MAIN OUTCOME MEASUREMENTS: Outcome measurements included time to perform the procedure, accuracy of the resection, and efficiency for the task. Accuracy was assessed according to variability of the surgical margin and misalignment between the mucosal layer and the seromuscular layer. Efficiency was assessed according to the duty ratio, which is the percentage of time spent for the main purposes compared with the total procedure time. RESULTS: Mean diameter of the specimen was not significantly different between the groups. All other assessment items were significantly superior in group B to those in group A (P < .05). LIMITATIONS: Ex vivo animal model study. CONCLUSION: We were able to perform EFTR procedures precisely and effectively by using a new multitasking platform compared with use of a conventional endoscope in a porcine model. A multitasking platform developed for NOTES procedures would be useful for advanced endoluminal surgery such as endoscopic submucosal dissection or EFTR as well as NOTES.
Authors: Philip W Y Chiu; S J Phee; Z Wang; Z Sun; Carmen C Poon; T Yamamoto; I Penny; Jennie Y Y Wong; James Y W Lau; K Y Ho Journal: Surg Endosc Date: 2013-08-29 Impact factor: 4.584