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Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract.

Mori H, Kobara H, Nishiyama N, Fujihara S, Masaki T - Gut Liver (2015)

Bottom Line: It is expected that gastroenterological endoscopists will use this surgery if device development is advanced.This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs.Development of a new surgical method using a multi-purpose flexible endoscope is therefore considered a socially urgent issue.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Neurology, Kagawa University, Kita, Japan.

ABSTRACT
Natural-orifice transluminal endoscopic surgery (NOTES) using flexible endoscopy has attracted attention as a minimally invasive surgical method that does not cause an operative wound on the body surface. However, minimizing the number of devices involved in endoscopic, compared to laparoscopic, surgeries has remained a challenge, causing endoscopic surgeries to gradually be phased out of use. If a flexible endoscopic full-thickness suturing device and a counter-traction device were developed to expand the surgical field for gastrointestinal-tract collapse, then endoscopic full-thickness resection using NOTES, which is seen as an extension of endoscopic submucosal dissection for full-thickness excision of tumors involving the gastrointestinal-tract wall, might become an extremely minimally invasive surgical method that could be used to resect only full-thickness lesions approached by the shortest distance via the mouth. It is expected that gastroenterological endoscopists will use this surgery if device development is advanced. This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs. Development of a new surgical method using a multi-purpose flexible endoscope is therefore considered a socially urgent issue.

No MeSH data available.


Related in: MedlinePlus

Relationship between output signals and directly measured pressures. In an in vivo experiment performed in dogs, there was a good correlation between the direct pressure from percutaneous endoscopic gastrostomy and the electrical signal from the Micro Electro Mechanical System hood.
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f10-gnl-09-590: Relationship between output signals and directly measured pressures. In an in vivo experiment performed in dogs, there was a good correlation between the direct pressure from percutaneous endoscopic gastrostomy and the electrical signal from the Micro Electro Mechanical System hood.

Mentions: We developed a hood equipped with a semiauto constant pressure device that is economical and has a simple structure. The hood equipped with the Micro Electro Mechanical System (MEMS) pressure sensor can measure the pressure of the tip of the endoscope in real time (Fig. 8). Based on the animal experiment, the MEMS sensor was downsized to 2 mm in width and 0.8 mm in thickness and implemented in the hood (Fig. 9A). The MEMS pressure sensor does not block the visual field of the endoscope at all (Fig. 9B), and the extrafine, 0.1-mm-diameter polyurethane conducting did not affect operation of the endoscope (Fig. 9C). In the in vivo dog experiment, there was a good correlation between the direct pressure from the percutaneous endoscopic gastrostomy and the electric signal from the MEMS hood. The compression and depression test (aspiration and insufflation test) was performed consecutively five times and showed an increase and decrease in internal pressure over time. Of five tests, we analyzed the results obtained from the four tests that resulted in accurate measurable data. There was a good correlation between the pressure-monitoring sensor (mm Hg) and the signal strength (V) of the MEMS hood. The signal strengths (in these four tests) ranged from −0.01 to 0.138 V and were, thus, well correlated with the actual pressure, which measured from 0 to 22 mm Hg via the pressure monitoring sensor (Fig. 10). Only by attaching the MEMS hood to the endoscope is it possible to measure intragastric pressure in real time.50


Review of Pure Endoscopic Full-Thickness Resection of the Upper Gastrointestinal Tract.

Mori H, Kobara H, Nishiyama N, Fujihara S, Masaki T - Gut Liver (2015)

Relationship between output signals and directly measured pressures. In an in vivo experiment performed in dogs, there was a good correlation between the direct pressure from percutaneous endoscopic gastrostomy and the electrical signal from the Micro Electro Mechanical System hood.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562775&req=5

f10-gnl-09-590: Relationship between output signals and directly measured pressures. In an in vivo experiment performed in dogs, there was a good correlation between the direct pressure from percutaneous endoscopic gastrostomy and the electrical signal from the Micro Electro Mechanical System hood.
Mentions: We developed a hood equipped with a semiauto constant pressure device that is economical and has a simple structure. The hood equipped with the Micro Electro Mechanical System (MEMS) pressure sensor can measure the pressure of the tip of the endoscope in real time (Fig. 8). Based on the animal experiment, the MEMS sensor was downsized to 2 mm in width and 0.8 mm in thickness and implemented in the hood (Fig. 9A). The MEMS pressure sensor does not block the visual field of the endoscope at all (Fig. 9B), and the extrafine, 0.1-mm-diameter polyurethane conducting did not affect operation of the endoscope (Fig. 9C). In the in vivo dog experiment, there was a good correlation between the direct pressure from the percutaneous endoscopic gastrostomy and the electric signal from the MEMS hood. The compression and depression test (aspiration and insufflation test) was performed consecutively five times and showed an increase and decrease in internal pressure over time. Of five tests, we analyzed the results obtained from the four tests that resulted in accurate measurable data. There was a good correlation between the pressure-monitoring sensor (mm Hg) and the signal strength (V) of the MEMS hood. The signal strengths (in these four tests) ranged from −0.01 to 0.138 V and were, thus, well correlated with the actual pressure, which measured from 0 to 22 mm Hg via the pressure monitoring sensor (Fig. 10). Only by attaching the MEMS hood to the endoscope is it possible to measure intragastric pressure in real time.50

Bottom Line: It is expected that gastroenterological endoscopists will use this surgery if device development is advanced.This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs.Development of a new surgical method using a multi-purpose flexible endoscope is therefore considered a socially urgent issue.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Neurology, Kagawa University, Kita, Japan.

ABSTRACT
Natural-orifice transluminal endoscopic surgery (NOTES) using flexible endoscopy has attracted attention as a minimally invasive surgical method that does not cause an operative wound on the body surface. However, minimizing the number of devices involved in endoscopic, compared to laparoscopic, surgeries has remained a challenge, causing endoscopic surgeries to gradually be phased out of use. If a flexible endoscopic full-thickness suturing device and a counter-traction device were developed to expand the surgical field for gastrointestinal-tract collapse, then endoscopic full-thickness resection using NOTES, which is seen as an extension of endoscopic submucosal dissection for full-thickness excision of tumors involving the gastrointestinal-tract wall, might become an extremely minimally invasive surgical method that could be used to resect only full-thickness lesions approached by the shortest distance via the mouth. It is expected that gastroenterological endoscopists will use this surgery if device development is advanced. This extremely minimally invasive surgery would have an immeasurable impact with regard to mitigating the burden on patients and reducing healthcare costs. Development of a new surgical method using a multi-purpose flexible endoscope is therefore considered a socially urgent issue.

No MeSH data available.


Related in: MedlinePlus