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A novel, simple, and dedicated device for endoscopic mucosal defect closure

OBJECTIVES: Endoscopic submucosal dissection (ESD) has become popular, but complications such as postoperative bleeding remain an issue. Although some methods of closing a mucosal defect with a snare and clips have been reported to be effective and safe, the snare is not a dedicated device, and the...

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Autores principales: Nose, Yohei, Takizawa, Kohei, Shiotsuki, Kazuo, Yamaguchi, Tsuyoshi, Agatsuma, Masaomi, Nitta, Shun, Yamashita, Kotaro, Saito, Takuro, Tanaka, Koji, Yamamoto, Kazuyoshi, Makino, Tomoki, Takahashi, Tsuyoshi, Kurokawa, Yukinori, Eguchi, Hidetoshi, Doki, Yuichiro, Nakajima, Kiyokazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302268/
https://www.ncbi.nlm.nih.gov/pubmed/35873505
http://dx.doi.org/10.1002/deo2.98
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author Nose, Yohei
Takizawa, Kohei
Shiotsuki, Kazuo
Yamaguchi, Tsuyoshi
Agatsuma, Masaomi
Nitta, Shun
Yamashita, Kotaro
Saito, Takuro
Tanaka, Koji
Yamamoto, Kazuyoshi
Makino, Tomoki
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Eguchi, Hidetoshi
Doki, Yuichiro
Nakajima, Kiyokazu
author_facet Nose, Yohei
Takizawa, Kohei
Shiotsuki, Kazuo
Yamaguchi, Tsuyoshi
Agatsuma, Masaomi
Nitta, Shun
Yamashita, Kotaro
Saito, Takuro
Tanaka, Koji
Yamamoto, Kazuyoshi
Makino, Tomoki
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Eguchi, Hidetoshi
Doki, Yuichiro
Nakajima, Kiyokazu
author_sort Nose, Yohei
collection PubMed
description OBJECTIVES: Endoscopic submucosal dissection (ESD) has become popular, but complications such as postoperative bleeding remain an issue. Although some methods of closing a mucosal defect with a snare and clips have been reported to be effective and safe, the snare is not a dedicated device, and the procedure is difficult and time‐consuming. We aimed to find an alternative method for defect closure after ESD by developing a dedicated device. METHODS: We have improved five prototypes. The load on the stopper when starting to tighten and loosen a loop and the maximum load on the stopper and the movement distance of the thread when sliding the stopper were measured five times for each prototype. With the 5th prototype, we finalized the design and named it FLEXLOOP. Additionally, the material and shape of the outer tube were improved. Then, the usability of FLEXLOOP was evaluated in pigs. The operation time for closing mucosal defects with the snare or FLEXLOOP was measured five times. RESULTS: We made FLEXLOOP, which had a lower load when sliding and a higher load when loosening than the snare. The improvement of the outer tube significantly reduced the load on the sheath when sliding it. We confirmed the feasibility of mucosal defect closure with FLEXLOOP in pigs. The median operation time was 563 s (range 340–679 s) with the snare and 355 s (range 303–455 s) with FLEXLOOP (p = 0.047). CONCLUSIONS: FLEXLOOP can be a promising option for defect closure after ESD.
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spelling pubmed-93022682022-07-22 A novel, simple, and dedicated device for endoscopic mucosal defect closure Nose, Yohei Takizawa, Kohei Shiotsuki, Kazuo Yamaguchi, Tsuyoshi Agatsuma, Masaomi Nitta, Shun Yamashita, Kotaro Saito, Takuro Tanaka, Koji Yamamoto, Kazuyoshi Makino, Tomoki Takahashi, Tsuyoshi Kurokawa, Yukinori Eguchi, Hidetoshi Doki, Yuichiro Nakajima, Kiyokazu DEN Open Original Articles OBJECTIVES: Endoscopic submucosal dissection (ESD) has become popular, but complications such as postoperative bleeding remain an issue. Although some methods of closing a mucosal defect with a snare and clips have been reported to be effective and safe, the snare is not a dedicated device, and the procedure is difficult and time‐consuming. We aimed to find an alternative method for defect closure after ESD by developing a dedicated device. METHODS: We have improved five prototypes. The load on the stopper when starting to tighten and loosen a loop and the maximum load on the stopper and the movement distance of the thread when sliding the stopper were measured five times for each prototype. With the 5th prototype, we finalized the design and named it FLEXLOOP. Additionally, the material and shape of the outer tube were improved. Then, the usability of FLEXLOOP was evaluated in pigs. The operation time for closing mucosal defects with the snare or FLEXLOOP was measured five times. RESULTS: We made FLEXLOOP, which had a lower load when sliding and a higher load when loosening than the snare. The improvement of the outer tube significantly reduced the load on the sheath when sliding it. We confirmed the feasibility of mucosal defect closure with FLEXLOOP in pigs. The median operation time was 563 s (range 340–679 s) with the snare and 355 s (range 303–455 s) with FLEXLOOP (p = 0.047). CONCLUSIONS: FLEXLOOP can be a promising option for defect closure after ESD. John Wiley and Sons Inc. 2022-03-09 /pmc/articles/PMC9302268/ /pubmed/35873505 http://dx.doi.org/10.1002/deo2.98 Text en © 2022 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Nose, Yohei
Takizawa, Kohei
Shiotsuki, Kazuo
Yamaguchi, Tsuyoshi
Agatsuma, Masaomi
Nitta, Shun
Yamashita, Kotaro
Saito, Takuro
Tanaka, Koji
Yamamoto, Kazuyoshi
Makino, Tomoki
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Eguchi, Hidetoshi
Doki, Yuichiro
Nakajima, Kiyokazu
A novel, simple, and dedicated device for endoscopic mucosal defect closure
title A novel, simple, and dedicated device for endoscopic mucosal defect closure
title_full A novel, simple, and dedicated device for endoscopic mucosal defect closure
title_fullStr A novel, simple, and dedicated device for endoscopic mucosal defect closure
title_full_unstemmed A novel, simple, and dedicated device for endoscopic mucosal defect closure
title_short A novel, simple, and dedicated device for endoscopic mucosal defect closure
title_sort novel, simple, and dedicated device for endoscopic mucosal defect closure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302268/
https://www.ncbi.nlm.nih.gov/pubmed/35873505
http://dx.doi.org/10.1002/deo2.98
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