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Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video).

Kwon CI, Kim G, Chung IK, Kim WH, Ko KH, Hong SP, Jeong S, Lee DH - Clin Endosc (2014)

Bottom Line: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives).The rate of adverse events and histological quality did not statistically differ between the modalities.ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

View Article: PubMed Central - PubMed

Affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

ABSTRACT

Background/aims: In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.

Methods: This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.

Results: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm(2)/sec vs. 1.57 mm(2)/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.

Conclusions: ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

No MeSH data available.


The novel versatile knife (Optimos knife; Taewoong Medical) used in this study. (A) The Optimos knife has a 1.9-mm-wide and 2.5-mm-long anchor-shaped tip, which can be smoothly and fully rotated by controlling the dial on the handle of the knife. (B) The outer sheath can perform the water injection function. (C) The handle of the knife.
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Figure 1: The novel versatile knife (Optimos knife; Taewoong Medical) used in this study. (A) The Optimos knife has a 1.9-mm-wide and 2.5-mm-long anchor-shaped tip, which can be smoothly and fully rotated by controlling the dial on the handle of the knife. (B) The outer sheath can perform the water injection function. (C) The handle of the knife.

Mentions: The Optimos knife (Fig. 1, Supplementary Video 1 [available online at http://www.e-ce.org/]) is capable of performing several steps of ESD (including marking, circumferential incision and cutting, dissection, vessel coagulation, and water injection) without the need to change the instrument. The Optimos knife also has several other distinguishing functions. The tip of the knife can be rotated fully and smoothly by adjusting the dial on the handle. The transparent sheath of the knife is suitable for obtaining the best visibility during the procedure. Its 1.9-mm-wide, 2.5-mm-long anchor-shaped tip allows a cutting method similar to that by an IT knife or Hook knife, a dissecting method similar to that of a Dual knife or Flex knife, and a hooking method (including vessel coagulation and cutting) similar to that of a Hook knife. The outer sheath enables water irrigation, as with a Flush knife (Fujifilm Medical, Tokyo, Japan) with water-jet function, and allows additional submucosal injection and saline irrigation without the need to change the device. The knife is eligible for a standard endoscope with a working channel width of ≥2.8 mm.


Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video).

Kwon CI, Kim G, Chung IK, Kim WH, Ko KH, Hong SP, Jeong S, Lee DH - Clin Endosc (2014)

The novel versatile knife (Optimos knife; Taewoong Medical) used in this study. (A) The Optimos knife has a 1.9-mm-wide and 2.5-mm-long anchor-shaped tip, which can be smoothly and fully rotated by controlling the dial on the handle of the knife. (B) The outer sheath can perform the water injection function. (C) The handle of the knife.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260103&req=5

Figure 1: The novel versatile knife (Optimos knife; Taewoong Medical) used in this study. (A) The Optimos knife has a 1.9-mm-wide and 2.5-mm-long anchor-shaped tip, which can be smoothly and fully rotated by controlling the dial on the handle of the knife. (B) The outer sheath can perform the water injection function. (C) The handle of the knife.
Mentions: The Optimos knife (Fig. 1, Supplementary Video 1 [available online at http://www.e-ce.org/]) is capable of performing several steps of ESD (including marking, circumferential incision and cutting, dissection, vessel coagulation, and water injection) without the need to change the instrument. The Optimos knife also has several other distinguishing functions. The tip of the knife can be rotated fully and smoothly by adjusting the dial on the handle. The transparent sheath of the knife is suitable for obtaining the best visibility during the procedure. Its 1.9-mm-wide, 2.5-mm-long anchor-shaped tip allows a cutting method similar to that by an IT knife or Hook knife, a dissecting method similar to that of a Dual knife or Flex knife, and a hooking method (including vessel coagulation and cutting) similar to that of a Hook knife. The outer sheath enables water irrigation, as with a Flush knife (Fujifilm Medical, Tokyo, Japan) with water-jet function, and allows additional submucosal injection and saline irrigation without the need to change the device. The knife is eligible for a standard endoscope with a working channel width of ≥2.8 mm.

Bottom Line: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives).The rate of adverse events and histological quality did not statistically differ between the modalities.ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

View Article: PubMed Central - PubMed

Affiliation: Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

ABSTRACT

Background/aims: In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.

Methods: This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.

Results: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm(2)/sec vs. 1.57 mm(2)/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.

Conclusions: ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

No MeSH data available.