BACKGROUND: The submucosal tunneling technique enables us to endoscopically access deeper tissue layers. Use of probe-based confocal laser endomicroscopy (pCLE) provides optical histologic imaging on the site. OBJECTIVE: To determine the technical feasibility of ex vivo and in vivo pCLE imaging of the muscularis propria and myenteric neurons by using submucosal endoscopy with a mucosal flap safety valve (SEMF). DESIGN: Acute porcine model study. SETTING: Animal laboratory. INTERVENTION: Two ex vivo and 6 in vivo porcine models were used. A submucosal space was created with SEMF, and a neuronal molecular probe was topically applied onto the muscularis. Confocal imaging of the stained muscularis was performed by using pCLE. The selected sites were sampled, and the histopathology of the sites was analyzed. MAIN OUTCOME MEASUREMENTS: The two main outcome measures were the procedural success rate of submucosal access and the correlation between pCLE and histologic images. RESULTS: Submucosal access to the pCLE study site was successful in all attempts (100%; 17/17 sites). The muscularis propria was visualized with pCLE in the ex vivo and in vivo porcine models in 83.3% of sites (20/24), and the neuron-like cells were identified in 41.7% of sites (10/24). LIMITATIONS: Animal experiment. CONCLUSION: The muscularis propria and myenteric neurons could be selectively visualized with pCLE in vivo.
BACKGROUND: The submucosal tunneling technique enables us to endoscopically access deeper tissue layers. Use of probe-based confocal laser endomicroscopy (pCLE) provides optical histologic imaging on the site. OBJECTIVE: To determine the technical feasibility of ex vivo and in vivo pCLE imaging of the muscularis propria and myenteric neurons by using submucosal endoscopy with a mucosal flap safety valve (SEMF). DESIGN: Acute porcine model study. SETTING: Animal laboratory. INTERVENTION: Two ex vivo and 6 in vivo porcine models were used. A submucosal space was created with SEMF, and a neuronal molecular probe was topically applied onto the muscularis. Confocal imaging of the stained muscularis was performed by using pCLE. The selected sites were sampled, and the histopathology of the sites was analyzed. MAIN OUTCOME MEASUREMENTS: The two main outcome measures were the procedural success rate of submucosal access and the correlation between pCLE and histologic images. RESULTS: Submucosal access to the pCLE study site was successful in all attempts (100%; 17/17 sites). The muscularis propria was visualized with pCLE in the ex vivo and in vivo porcine models in 83.3% of sites (20/24), and the neuron-like cells were identified in 41.7% of sites (10/24). LIMITATIONS: Animal experiment. CONCLUSION: The muscularis propria and myenteric neurons could be selectively visualized with pCLE in vivo.
Authors: Matthias Trottmann; Ronald Sroka; Herbert Stepp; Bernhard Liedl; Armin J Becker; Christian G Stief; Sabine Kölle Journal: Lasers Med Sci Date: 2015-10-30 Impact factor: 3.161
Authors: Elizabeth Rajan; Christopher J Gostout; Eduardo Aimore Bonin; Erica A Moran; Richard G Locke; Lawrence A Szarka; Nicholas J Talley; Jodie L Deters; Charles A Miller; Mary A Knipschield; Matthew S Lurken; Gary J Stoltz; Cheryl E Bernard; Madhusudan Grover; Gianrico Farrugia Journal: Gastrointest Endosc Date: 2012-11 Impact factor: 9.427
Authors: Elizabeth Rajan; Christopher J Gostout; Louis M Wong Kee Song; Lawrence A Szarka; Purna C Kashyap; Thomas C Smyrk; Juliane Bingener; Jodie L Deters; Mary A Knipschield; Cheryl E Bernard; Gianrico Farrugia Journal: Gastrointest Endosc Date: 2016-04-27 Impact factor: 9.427