Ippei Matsuzaki1, Masashi Hattori1, Ken Hirose1, Masaya Esaki1, Masakatsu Yoshikawa1, Takio Yokoi2, Makoto Kobayashi3, Ryoji Miyahara4, Yoshiki Hirooka5, Hidemi Goto4. 1. Department of Gastroenterology, Yamashita Hospital, Ichinomiya, Japan. 2. Department of Pathology, Yamashita Hospital, Ichinomiya, Japan. 3. Department of Gastroenterology, Yokkaichi Municipal Hospital, Mie, Japan. 4. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 5. Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Abstract
BACKGROUND AND AIMS: The feasibility of magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD) using a neodymium magnet for gastric lesions has not been clarified. The aim of study was to evaluate the feasibility of MAG-ESD using neodymium magnets while treating gastric lesions. METHODS: This prospective trial was conducted at the Yamashita Hospital. MAG-ESD was performed for 50 gastric lesions using an insulated-tip knife. The magnetic anchor consisted of an internal neodymium magnet attached to a hemoclip with 3-0 silk. The external and internal magnets were made from the neodymium magnet. The feasibility of traction using MAG-ESD, en bloc resection rate, complete en bloc resection rate, time required for preparation and attaching the magnetic anchor, procedure time, rate of retrieval of the magnetic anchors, and adverse events were evaluated. RESULTS: Fifty patients (median lesion size, 20 mm [range, 5-100]) were enrolled. MAG-ESDs were successfully performed for all 50 gastric lesions. Adequate counter-traction was obtained using the external magnet. En bloc resections were achieved and complete en bloc resections confirmed in all cases without adverse events. Attaching the magnetic anchor required a median of 6 minutes (range, 2-14). The median procedure time was 49 minutes (range, 15-301), and the magnetic anchors could be retrieved in all cases. CONCLUSIONS: This study clearly demonstrated the feasibility of this MAG-ESD in the stomach. We hope this procedure will facilitate the resection of difficult lesions. (Clinical trial registration number: UMIN000024100.).
BACKGROUND AND AIMS: The feasibility of magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD) using a neodymium magnet for gastric lesions has not been clarified. The aim of study was to evaluate the feasibility of MAG-ESD using neodymium magnets while treating gastric lesions. METHODS: This prospective trial was conducted at the Yamashita Hospital. MAG-ESD was performed for 50 gastric lesions using an insulated-tip knife. The magnetic anchor consisted of an internal neodymium magnet attached to a hemoclip with 3-0 silk. The external and internal magnets were made from the neodymium magnet. The feasibility of traction using MAG-ESD, en bloc resection rate, complete en bloc resection rate, time required for preparation and attaching the magnetic anchor, procedure time, rate of retrieval of the magnetic anchors, and adverse events were evaluated. RESULTS: Fifty patients (median lesion size, 20 mm [range, 5-100]) were enrolled. MAG-ESDs were successfully performed for all 50 gastric lesions. Adequate counter-traction was obtained using the external magnet. En bloc resections were achieved and complete en bloc resections confirmed in all cases without adverse events. Attaching the magnetic anchor required a median of 6 minutes (range, 2-14). The median procedure time was 49 minutes (range, 15-301), and the magnetic anchors could be retrieved in all cases. CONCLUSIONS: This study clearly demonstrated the feasibility of this MAG-ESD in the stomach. We hope this procedure will facilitate the resection of difficult lesions. (Clinical trial registration number: UMIN000024100.).
Authors: Akira Dobashi; Andrew C Storm; Louis M Wong Kee Song; Jodie L Deters; Charles A Miller; Crystal J Tholen; Christopher J Gostout; Elizabeth Rajan Journal: Surg Endosc Date: 2019-05-08 Impact factor: 4.584
Authors: Akira Dobashi; Andrew C Storm; Louis M Wong Kee Song; Christopher J Gostout; Jodie L Deters; Charles A Miller; Mary A Knipschield; Elizabeth Rajan Journal: Surg Endosc Date: 2018-10-23 Impact factor: 4.584