Hisashi Hara, MD, Sam Sharma, MD, Jeffrey Milsom, MD, FACS. Weill Cornell Medical College
Introduction: Underwater ESD was developed to improve visualization whilst performing the procedure and minimize burn artifact using water as a heat sink.
It’s utility in the colon is limited due to lack of fluid containment within the intestine.
A double balloon system may be advantageous in this situation – forming a water-tight area between the two balloons.
We considered using a Double Balloon (DB) device with independent inflation control and variable distance function to overcome these limitations, in particular providing a water-tight seal.
Aims: To evaluate the technical feasibility and safety in an ex-vivo recto-sigmoid intestine model.
Materials and Methods: A 3cm diameter virtual lesion 20cm from the anal verge was marked using electrosurgery on the mucosal surface of ex-vivo porcine recto-sigmoid intestine.
Double-balloon underwater assisted ESD was performed by:
Olympus PCF180AL colonoscope.
DiLumen® device (Lumendi, LLC).
ERBE electrosurgical generator.
No ESD cap was used.
The procedure was recorded (both endoscopic and external views).
Results: Complete resection of the lesion was achieved with no perforations. Visibility was enhanced.
Conclusions: Double balloon assisted underwater ESD is technically feasible.
This technique may have superiority over conventional ESD techniques e.g. visualization.
This remains a novel method, currently in a state of evolution.
Despite the early nature of this feasibility study, DB-assisted techniques promise to expand the capabilities of endoluminal therapies.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80482
Program Number: V075
Presentation Session: Endoscopy Video Session
Presentation Type: Video